Dr. Paul Rubin, board certified pediatric dentist, may refer you to an orthodontist that may recommend a Two-Phase (Interceptive) Orthodontic Treatment that allows your orthodontist to take advantage of your child’s growth and development.
Some orthodontic conditions are easier to treat if they are intercepted and corrected early. Problems that could be severe, if left untreated, can be prevented when the orthodontist has some control over where the permanent teeth come in. Through a specialized process, orthodontists can address the structure of your child’s jaw and teeth while the primary (baby) teeth are still in place. Generally by age 7, a child’s mouth has enough sound structure for the orthodontist to track how it will develop as the permanent teeth begin to erupt. Interceptive treatment allows your doctor to take advantage of your child’s growth and development to complement any needed orthodontics.
Orthodontic conditions that may require early interceptive treatment include:
- Under bites
- Cross bites
- Open bites
- Deep bites
- Severely maligned teeth
- Teeth emerging out of sequence
- Missing teeth (congenital or accidental)
- Ankylosed teeth- primary tooth stops erupting and causes displacement of the permanent tooth
While conventional orthodontics require only one comprehensive treatment (usually 12-30 months) after most of the permanent teeth have erupted, interceptive treatment occurs in stages. If it is decided that your child would benefit from interceptive treatment, Orthodontists recommend a two-phase approach, which encompasses tooth straightening and physical, facial changes. Phase I typically begins right away while most of the primary teeth are still present, generally between the ages of 7 and 10. Phase II happens later, and is determined by your child’s growth and corrective dental needs.
The basic goal of Phase I is to create a more favorable environment in which permanent teeth can erupt. Preventing problems before they occur is a key component of Phase I. Phase II treatment is typically much less complex when early intervention occurs. Because many poor bites result from the upper and lower jaws growing at different speeds, Phase I treatment may include altering jaw growth patterns. Early correction can help align the jaws and avoid the need for surgery.
Phase I (Interceptive) Orthodontic Treatment
Phase I is designed to:
- Intercept and prevent developing problems
- Correct harmful oral habits
- Enable correct chewing and biting
- Guide jawbone growth to correct alignment enabling teeth to come in straight
- Guide the eruption of permanent teeth into a desirable position
During Phase I, your child will have a removable appliance (a type of retainer) and/or braces on the permanent teeth, which have already emerged. If crowding or a cross bite is an issue, an expander may be recommended. These appliances direct the growth relationship of the upper and lower jaws and provide room for the eruption of the permanent teeth.
At the end of Phase I, which usually lasts 6-12 months, the teeth are not in their final positions. A resting period typically is needed between Phase I and Phase II in order to allow the eruption of the remaining permanent teeth and to give the existing permanent teeth some freedom of movement. The interceptive treatment in Phase I is key in creating this optimal environment.
Patients will need to have regular orthodontic visits (about every 6 months) to monitor the progress during the resting period. Occasionally, the removal of certain primary teeth is necessary to aid in the eruption process.
Phase II (Interceptive) Orthodontic Treatment
Most patients will require a second phase of treatment once all of the permanent teeth have erupted. Phase II typically involves placing traditional braces on all of the teeth and, as with any conventional orthodontic treatment, requires periodic visits and adjustments. Phase II is designed to:
- Move the permanent teeth into their final desired position
- Continue to improve the functionality of teeth
- Enhance facial appearance and self-esteem
The average length of time for Phase II is 24 months. Once the braces are removed, a retainer is required for a time to ensure the teeth stay in place. By utilizing the two-phase interceptive approach, orthodontists can maximize the opportunity to accomplish an ideal functional and aesthetic result that will enhance your child’s dental health and stability for a lifetime.