Orthodontic treatment can be initiated on certain types of tooth problems before all the permanent teeth have erupted. The type of treatment varies with the problem and can include space regaining, arch widening for crowded conditions, correction of overbite (upper teeth appear to protrude), and adverse habits such as thumb sucking. Early treatment is indicated when the front teeth protrude so much that lips cannot be closed without strain or when the front teeth are so crowded or poorly arranged that normal development cannot take place.

FIRST PHASE TREATMENT (bone development and tooth guidance)

Different appliances, removable or fixed (cemented), are used to gently develop the bones containing the unerupted permanent teeth. A larger dental arch means more room for erupting teeth as well as a nicer smile. It is our objective to pull permanent teeth only when adequate space cannot be made, or facial esthetics requires tooth removal. In addition, certain types of growth abnormalities can only be corrected if started before the growth cycle is complete.

Advantages of Early Treatment

• Utilizes maximum advantage of growth, essential to successful treatment.
• Improves the relationship of the jaws, allowing more normal future development.
• Improves facial appearance.
• May eliminate the need for extraction of permanent teeth.
• Corrects overbite, so front teeth are less susceptible to injury.
• Younger patients are usually very cooperative.
• May not need further treatment when older.

Disadvantages of Early Treatment

• May require further treatment (Second Phase).
• With two phases, total time in appliances is longer.
• With two phases, the cost is greater.

SECOND PHASE TREATMENT (tooth correction)

During a First Phase we have no control over unerupted teeth. If, after these teeth have erupted, problems still exist, treatment should be re-initiated. The patient is usually 12-13 years old and the "braces phase" takes from 12-24 months, depending on the severity of the problem remaining.