ORTHODONTIC TREATMENT TIMING:
Ideally, orthodontists prefer to wait until most or all of the permanent (adult) teeth have erupted before starting comprehensive treatment.
- Average age for girls = 11 years old
- Average age for boys = 12 years old
However, one or more of the following problems may be an indication for interceptive (early) orthodontic treatment.
1. Posterior Crossbite
- Unilateral or bilateral involving at least the 1st molars.
- Early treatment is preferable to expand the upper jaw before fusion of mid-palatal sutures (fibrous junction between upper jaw and base of skull) at around age 10.
- Treatment Time = 6-12 months.
- Consequences of No Treatment – Asymmetric jaw growth that can become permanent.
2. Anterior Crossbite Related to a Class III bite (Underbite)
- Clinical Signs - Minimal or negative (reverse) overjet and/or concave profile.
3. Traumatic Occlusion / Bite
- Early treatment is important because tooth loss can be the “worst case scenario”
- Treatment Time = 3-6 months.
4. Prolonged Finger or Thumb Sucking Habit (after age 7)
- Clinical Signs – Anterior open bite, posterior crossbite, flared or protrusive upper front teeth.
- Treatment Time = 6-9 months.
5. Ectopic Eruption and Impacting Teeth
- Most common ectopically erupting teeth – Upper 1st molars, especially if seen more gingival than primary 2nd molars or even partially under them.
- Most common impacted teeth – 3rd molars (wisdom teeth) followed by upper canines.
- Clinical Signs – Retained primary canines (past age 13-14).
- Early detection can be accomplished by taking a panoramic x-ray at age 10.
- Consequences of No Treatment – Root resorption of lateral incisors, ankylosis of permanent upper canines, longer and more expensive treatment.
6. Esthetic Appearance of Teeth is Negatively Impacting Patient’s Self-Esteem
Information courtesy of:
Edward R. Altherr, DMD, MS, PA
1011 W. Williams St., Ste 101, Apex, NC 27502