Orthodontics for Children

Early Treatment Phase 1 Interceptive

The goal of the first phase of treatment is to develop both the upper and lower jaws sufficiently to accommodate all of the permanent teeth.

Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper or lower jaw that is growing too much or not enough, or is too wide or too narrow can be recognized at an early age. If children over four years of age have these jaw discrepancies, they are usually candidates for early orthodontic/orthopedic evaluation and treatment.

According to the American Association of Orthodontists, all children should see an orthodontist by the age of seven. Because children are growing rapidly, they can benefit enormously from an early (interceptive) phase of orthodontic treatment.

Orthodontic appliances can be used to correct the jaw shape and direct the growth toward an ideal relationship between the upper and lower jaws. A good foundation can be established thereby providing adequate room for eruption of all the permanent teeth.

Early interceptive treatment may prevent:

The later removal of permanent teeth to correct over-crowding
Future surgical procedures to align the upper and lower jaws
The development of a poor self-esteem if the child's smile is unattractive

Depending on the severity of the problems, interceptive treatment may also decrease the length of time necessary for the second phase of treatment. Leaving a malocclusion untreated until all of the permanent teeth erupt could result in a jaw discrepancy too severe to allow achievement of an ideal result with braces alone. Extended treatment times and sometimes orthognathic surgery become treatement requirements if a problem is allowed to persist into late adolescence.

Diagnostic records are necessary for early treatment. These records allow Dr. Rizkallah to determine the appropriate treatment plan, the type of appliances needed, and the duration of treatment. Typically, Phase One treatment last approximately 9-18 months. Regular check ups are usually 4 to 10 weeks apart.

Intermediate (Retention) Period

Somerville Orthodontics Massachusetts MA

During this period the remaining permanent teeth are allowed to erupt. Retention and/or tooth guidance appliances may be recommended at the end of the First Phase. Sometimes retainers are used for a short time only as they may interfere with the eruption of the adult teeth.

In this case it is best to allow the existing permanent teeth some freedom of movement while final eruption of the teeth takes place. A successful first phase will have created enough room for the teeth to find an adequate eruption path and prevent impaction and displacement problems.

It is important to understand that at the end of the first phase of treatment, teeth are not in their final positions. This is generally accomplished in the second (corrective) phase of treatment. Sometimes, for those stubborn baby teeth, selective removal of certain baby teeth are in the best interest of enhancing eruption during this resting phase. Should this be necessary, it will be discussed with you. Dr. Rizkallah likes to give "homework" to children needing to have certain baby teeth removed. He will instruct the child to "wiggle" certain teeth. After a few months of wiggling, if the obstinate tooth is not out, Dr. Rizkallah will likely refer you and your child to your dentist to have those difficult "buggers" removed.

Periodic recall appointments for observation will continue to be necessary throughout this intermediate phase on a four to eight month basis because sometimes when a patient is treated with a two-phase treatment, the permanent teeth erupt more rapidly than anticipated. Should this occur, you will be advised as to the timing and need for a second phase of treatment.

Early Treatment Phase 2 Corrective

Each tooth has an exact location in the mouth where it is in harmony with the cheeks, tongue, jaws, jaw joints and other teeth. When this equilibrium is established, the teeth will function together properly. With good home care and retainer wear your teeth should stay healthy, stable comfortable and look attractive. This is the goal of the second (corrective) phase of treatment.

Updated diagnostic records will need to be taken and a Phase two treatment plan made.

Now that the first phase of treatment has resolved much of the original malocclusion, the second phase will be shorter and adult teeth have been saved.

The second phase is initiated when most of the permanent teeth have erupted, and usually requires braces for on all the teeth for a period of 12-24 months. Retainers are worn after this phase to hold the teeth in their new corrected positions.

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