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At a young age, it is possible to create dramatic orthodontic and orthopedic changes in a quick and noninvasive manner since a great amount of growth – and thus potential for stable change – exists at this time; this is termed optimization. Moreover, by addressing developing problems before they worsen or become permanent, early intervention can also help avert the need for more complicated and invasive treatments such as jaw surgery and tooth extractions later in life; this is termed prevention.
Early interventions that optimize growth & development and/or prevent complex future problems are often referred to as Interceptive Care or Phase 1 Treatment.
Not all children require interceptive orthodontic treatment, but all children should be screened by an orthodontist no later than the age of 7 to see if they do. Indications for interceptive orthodontic treatment may include:
When interceptive treatment is indicated, the goal is to quickly correct the problem to prevent it from getting worse or causing additional problems that are more difficult and complex to treat later on. Because not all the permanent teeth are present in childhood, however, it is expected that a second phase of orthodontic care to perfect the bite and smile will be needed during adolescence – this second phase of treatment is usually quite short since the teeth are generally quite close to where they should be thanks to the first phase of treatment
Orthopedic corrections aim to optimize growth & development so that jaw discrepancies may be corrected via comfortable, noninvasive approaches.
Depending on the type of orthopedic correction and the developmental stage of a given person, the age at which the growth & development optimization treatment should begin varies between 6 and 14 years old. Below is a case of orthopedic correction performed between the ages of 11 and 13.
By mid to late adolescence, growth is essentially complete, and the potential for growth & development optimization is thus lost. Excellent results can still be achieved in the absence of growth potential, but if the jaw discrepancy is significant, tooth extractions and/or jaw surgery may be required to reach the desired goal.
Occasionally, some adult teeth do not follow the proper developmental path during growth, and they therefore remain stuck in the jaw bone or come out in the wrong place. Reasons for this include early loss of baby teeth, tooth crowding, and genetics.
Whatever the cause, it is almost always preferable to correct such problems before they fully manifest themselves so that unwanted side-effects are prevented from occurring. This is because some side-effects that can be associated with improperly positioned or severely crowded teeth – such as damage to neighbouring teeth, damage to gums, abnormal tooth wear, and subsequent asymmetric growth – are irreversible. Moreover, correcting a problem after it fully manifests itself is generally more complex and time-consuming, and the result is generally less stable.
Habits such as thumb-sucking and mouth-breathing can have a permanent negative effect on the teeth and facial bones if they are not stopped by the age of 6 or 7.
The preferred habit therapy is to simply explain to a child why he or she should make an effort to stop the habit, but in cases where a child is not able to stop on his or her own, comfortable and noninvasive habit-breaking therapies exist. Such therapies generally only take a few months, and once the habit is broken, normal growth & development ensues, and any negative effects produced to that point disappear over time.
This is an example of a malocclusion caused by thumb-sucking. The habit was stopped and an orthodontic treatment was performed afterwards to further improve the esthetics and bite:
For esthetically-motivated orthodontic corrections, it is generally preferable to wait until late childhood or early adolescence before intervening so that the entire treatment can be completed in a single phase.
However, in situations where a child is experiencing hardships because of an esthetic problem with his or her smile, an early intervention to quickly correct the problem is indicated to prevent the development of any lasting psychological effects.