Early Treatment

Early treatment refers to orthodontic treatment started before the child has most or all of their adult teeth. In addition, early treatment most often occurs prior to the onset of the child’s pubertal growth spurt. This treatment is often geared towards correcting tooth and/or jaw malpositions, improving function, aesthetics and sometimes the self-confidence of the child.

When is Early Treatment recommended?

Most often, the successful completion of early treatment does not eliminate the need for braces at a later stage when all the adult teeth have erupted. As a result, children who go through two phases of orthodontic treatment usually experience longer overall treatment times as well as higher combined treatment fees. With this in mind, Dr. Korne only recommends early treatment for those conditions which merit intervention based on accepted scientific research.

As such, early treatment is recommended for the following orthodontic conditions:

  • An “underbite” or developing “class III.” In this scenario, the lower teeth are in front of the upper teeth. This problem can most often be intercepted to avoid more complicated treatments later on. A facemask or “reverse headgear” is the appliance of choice;
  • “Crossbite” of an anterior tooth causing gum recession, wear of the permanent tooth or shift of the lower jaw upon closure. This can be corrected with a removable retainer or braces cemented to select teeth;
  • Posterior “crossbites” resulting from a narrow upper jaw. Expansion of the upper jaw with an expander cemented to the upper teeth occurs rapidly over a 2-3 week period; the expander is often left in place for an additional 6 months for stabilization;
  • A finger/thumb sucking habit. A persistent sucking habit beyond age 5 should be intercepted with a “reminder” appliance cemented to the upper teeth. These habits are almost always stopped shortly after the insertion of this appliance; and
  • Impacted teeth or teeth that erupt away from their normal target. Occasionally, a short period of treatment is necessary to position incisor teeth in their proper position.

According to the Research

Orthodontic research in the last 10 years (References 1-2) has clearly shown that early treatment for “class II” problems (prominent upper front teeth or “buck teeth”) is of little value and may actually cause other problems.

Children undergoing two-phase treatment for class II problems often experience “burnout” from lengthy treatment. Other disadvantages can include increased cost, potential root resorption (“blunting” of the roots) and enamel decalcification or stains on the teeth.

Class II problems are best addressed during the child’s pubertal growth spurt, when the lower jaw is growing most rapidly. This time most often corresponds to when the child has most, if not all, of their adult teeth. As a result, Dr. Korne will carefully monitor the child’s dental development and physical maturation in order to treat these problems with one comprehensive phase of treatment.

References:
1 Tulloch, Proffit, Phillips. Outcomes in a 2-phase randomized clinical trial of early class II treatment. American Journal of Orthodontics & Dentofacial Orthopedics. 125(6):657-667, June 2004
2 Harrison, O’Brien, Worthington. Orthodontic treatment for prominent upper front teeth in children. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD00345.DOI:10.1002/14651858.CD003452.pub2