Orthodontic Treatment Timing

The Reasons

• Decreased time in braces and fewer appointments: By waiting until most, if not all, permanent teeth have erupted, orthodontic treatment can be more efficient. This means that patients will spend less time wearing braces and attending appointments with their orthodontist.
• Less possibility of enamel decalcification and root shortening: Delaying orthodontic treatment allows for the natural growth and development of teeth, which reduces the risk of enamel decalcification (white spots on teeth) and root shortening.
• Less time absent from school or work: Waiting until most permanent teeth have come in also means that patients won't have to miss as much school or take as many days off work for their orthodontic appointments.
• Less opportunity for broken braces: When all permanent teeth are present, there is less chance of brackets coming loose or wires snapping during daily activities like eating or playing sports.
• Less out-of-pocket expenses: Lastly, waiting until most permanent teeth have erupted can lead to lower out-of-pocket expenses for additional treatments that may arise if early intervention is pursued. 
• Increased treatment effectiveness: Bone growth is occurring more rapidly during the adolescent years, making it an ideal time for orthodontic treatment. Treatment effectiveness is significantly increased when orthodontic procedures are performed on patients whose permanent teeth have fully erupted. 
• Ensures better adherence to instructions: By waiting until most, if not all, permanent teeth have erupted, patients are generally more mature and better able to comprehend instructions and follow through with necessary oral care practices.
• Significant cost savings: Opting for a one-phase treatment plan rather than a two-phase program can offer significant cost savings. It eliminates the need for multiple visits and allows for comprehensive correction without any unnecessary delays or additional expenses.
• Eliminates the need for ongoing retainers: Delaying orthodontic treatment until most permanent teeth have emerged also eliminates the need for ongoing retainers between different phases of treatment.

The most optimal time to have these benefits may vary with the individual child, but for most children, it is between the ages of 12 and 14. During this crucial developmental period, orthodontic treatment can yield remarkable results. By addressing any dental irregularities at an early stage within this timeframe, braces typically need to be worn for a shorter duration – usually around 18 to 24 months. This targeted approach significantly reduces the overall treatment time required compared to starting later in adolescence or adulthood, where braces may need to be worn for a more extended period of 3 to 4 years or even longer.

Exceptions

There are certain orthodontic conditions that necessitate a limited duration of early intervention, primarily due to the unavailability of alternative solutions at a later stage or the potential for further harm if delayed. These include:

• Cross bites: Early treatment becomes necessary when cross bites are present, particularly if they are causing the lower jaw to shift. By addressing this issue promptly, orthodontists can prevent further complications and ensure that future correction is possible.
• Severe jaw growth imbalances: When there are significant imbalances in jaw growth, early treatment becomes essential. An upper jaw that is positioned too far back can lead to various difficulties later on, making it crucial to address this condition during its early stages.
• Protruding upper front teeth that are at risk for injury: If a patient has protruding upper front teeth that pose a risk of injury, immediate attention is required. 

• Space maintenance for early loss of primary (baby) teeth: In cases where primary teeth are prematurely lost, space maintenance through early orthodontic intervention plays a vital role. This ensures proper spacing for permanent teeth and helps avoid more extensive issues in the future.
• Excessive crowding or deep bites causing damage to teeth and/or gums: Excessive crowding or deep bites can cause significant damage not only to the teeth but also to the gums. To prevent further harm and maintain oral health, timely intervention by an orthodontist is indispensable.

Additionally, if a young patient is experiencing psychological or social distress due to the presence of crooked upper front teeth, orthodontic intervention in the form of a brief period of partial braces can yield remarkable improvements in both their smile and self-image. The use of these braces serves as a powerful tool in addressing not only the physical alignment concerns but also the emotional wellbeing of our patients. By correcting misaligned teeth at an early stage, we aim to alleviate any potential negative impact on their confidence and overall mental health. Rest assured that while this initial treatment may provide temporary relief, braces will still be needed later when all permanent teeth have fully erupted. Our dedicated team is always available to address any further inquiries you may have regarding this matter or other topics related to orthodontic care. 

Feel free to reach out to our office; we are here for your peace of mind and dental wellbeing.

References

Johnston, L. Answers in Search of Questioners. Am J Orthod Dentofacial Orthop 2002; 121:552-3.

King, G; McGorray, S; Wheeler, T; Dolce, C; and Taylor, M. Comparison of Peer Assessment Ratings (PAR) from 1-Phase and 2-Phase Treatment Protocols for Class II Malocclusions. Am J Orthod Dentofacial Orthop 2003; 123:489-496.

Pancherz ,H. Treatment Timing and Outcome. Am J Orthod Dentofacial Orthop 2002; 121:559.

Profitt, W. and Tulloch, J. Preadolescent Class II Problems: Treat Now or Wait? Am J Orthod Dentofacial Orthop 2002; 121:560-2.