Young Patients-Othro

Young Patient Ortho


     How early should we start?


Mothers and fathers are approaching us daily about their children’s improper bite, crowded teeth, protruding teeth and spaces between the teeth. Today’s parents do not accept the answers given by some dentists and orthodontists when observing that their son or daughter has a problem. “No treatment is indicated at this time, the patient is too young, the malocclusion will be observed and treated when the permanent teeth erupt in.” For dentists that are trained with a preventive philosophy, this approach seems completely illogical when statistics have proven that malocclusions when left untreated worsen over time. The term “supervised neglect” seems very appropriate.

The term “mixed dentition” is used to describe the stage when the adult teeth start to erupt into the arches. One of the main reasons why your dentist should treat children during the mixed dentition stage of development is that there is such a high incidence of malocclusion in children at and before this stage. This was quite evident from the Burlington Growth Study, Toronto, Canada, where it was revealed that 75% of children, age 12, have some form of malocclusion.

Since 90% of the face is developed by age 12, practitioners must treat early if they want to guide and, in fact, modify the growth of younger patients. In our office we emphasize a functional-orthopedic philosophy and favor a two phase orthodontic treatment.

Phase 1
Mixed Dentition (Orthopedic Phase)


Thumb sucking, finger habits, tongue thrusts, airway problems including mouth breathing and snoring and jaw joint (TMJ) problems must be corrected early with functional appliances. Skeletal problems such as constricted maxillary or mandibular arches and retrognathic mandibles are best treated as early as possible with functional appliances in the mixed dentition period of growth.


Phase 2
Permanent Dentition (Orthodontic Phase)


Dental problems are solved with straight wire appliances (fixed) braces in permanent dentition.

One of the main advantages of early treatment is the majority of malocclusions can be corrected without extraction of permanent teeth and non-surgically. Parents favor the use of functional appliances to correct under-developed mandibles in the mixed dentition stage rather than delay treatment until all the permanent teeth erupt. To general dentists who are trained to use jaw repositioning appliances such as the Twin BlockTM, Rick-A-Nator and Schwartz appliances, we find it ludicrous to wait when children can be treated in 7 to 12 months non-surgically using functional appliances.

The Benefits of Early Treatment


For those patients who have clear indications for early intervention, early treatment presents the opportunity to:

  • Influence jaw growth in a positive manner
  • Harmonize width of the dental arches
  • Improve eruption patterns
  • Lower risk of trauma to protruded upper incisors
  • Correct harmful oral habits
  • Improve aesthetics and self-esteem
  • Simplify and/or shorten treatment time for later corrective orthodontics
  • Reduce likelihood of impacted permanent teeth
  • Improve some speech problems
  • Preserve/gain space for erupting permanent teeth
  • Improved breathing / airway problems

*The above thoughts have been shared by Dr. Brock Rondeau – Diplomate of the International Board of Orthodontics, 1998

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