The Importance Of Early Orthodontic Treatment


Timing is everything – even when it comes to your child’s orthodontic treatment. Early orthodontic treatment, also called “interceptive” treatment, means treatment that is performed while some baby teeth are still present.

The American Association of Orthodontists (AAO) recommends that your child’s first check-up with an orthodontist be performed when an orthodontic problem is first recognized, but no later than age 7. Why age 7? By then, your child has enough permanent teeth for an orthodontist to evaluate the developing teeth and the jaws, which in turn can provide a wealth of information. AAO orthodontists are trained to spot subtle problems even in young children.

There are generally three outcomes of an initial check-up:

  1. No treatment is expected to be necessary.
  2. Treatment may be needed in the future, so the child will be followed periodically while the face and jaws continue to grow.
  3. There is a problem that lends itself to early treatment.

While there are many orthodontic problems that orthodontists agree are best treated after all permanent teeth have come in, early orthodontic treatment can be in a patient’s best interests if their problem could become more serious over time if left untreated. The goal of early treatment is to intercept the developing problem, eliminate the cause, guide the growth of facial and jawbones, and provide adequate space for incoming permanent teeth. A patient may require a second course of treatment after all permanent teeth have come in to move those teeth into their best positions.

The kinds of problems orthodontists may recommend treating while a child still has some baby teeth include:

  1. Underbites – when the lower front teeth are ahead of the upper front teeth
  2. Crossbites – when the jaw shifts to one side
  3. Very crowded teeth
  4. Excessively spaced teeth
  5. Extra or missing teeth
  6. Teeth that meet abnormally, or don’t meet at all
  7. Thumb-, finger-, or pacifier- sucking that is affecting the teeth or jaw growth

Some of these orthodontic problems are inherited, while others may result from accidents, dental disease, or abnormal swallowing.

Early orthodontic treatment can take many forms. The orthodontist could prescribe a fixed or removable “appliance” – a device used to move teeth, change the position of the jaw, or hold teeth in place to bring about desirable changes. Sometimes no appliances are necessary. Rather, the removal of some baby teeth may help the permanent teeth erupt better. The extractions will be timed to take the best advantage of a patient’s growth and development.

Regardless of how treatment goals are reached, the bottom line is that some orthodontic problems may be easier to correct if they are found and treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.

Early orthodontic treatment defined

Early orthodontic treatment, also called phase I of orthodontic treatment, is designed to help young children who still have some or all of their primary teeth, which may prevent improper growth and alignment of permanent teeth. There are different types of options available in early orthodontic treatment, depending on the specific issue the child has. The three most common types of treatment include wearing a palatal expander, partial braces, and a retainer. The primary goal is often to address skeletal issues with the jaw and alignment before or soon after permanent teeth emerge. 

When to consider early orthodontic treatment

Early orthodontic treatment is a good idea if the general dentist or orthodontist notices an issue with the child’s jaw or teeth alignment after permanent teeth come through. Several concerns that they might check for include:

Early orthodontic treatment is in a way a head start for phase II orthodontics. It reduces the need for treatments such as metal braces or clear aligners at a later age. 

Children who may not need early orthodontic treatment

It is important to note that not every child requires early orthodontic treatment. Children who do not have any noticeable concerns with the alignment of their jaw or teeth should likely wait until phase II orthodontics for treatment. The best way to determine if a child can benefit from early orthodontic treatment is to consider visiting with an orthodontist for a consultation, during which they can order dental X-rays and conduct an oral examination to see how the permanent teeth and the jaw are developing. 

At what age should my child visit an orthodontist?

Many orthodontists recommend having children come in for a checkup visit as early as six or seven years of age. As mentioned, many do not need treatment until later, but an early visit can provide the orthodontist and the parent with a better idea of what treatment may be needed at a later age and what can be done during phase I to reduce the need for treatment later.