Young children are evaluated while permanent teeth erupt into the oral cavity. This process, which commences at around age 6, usually begins with appearance of the lower incisors (front teeth) and six-year molars (back teeth) and progresses for several more years.
There are many reasons for monitoring children during this period.
- One, we watch to make sure there is enough room for permanent teeth to grow into the mouth.
- Two, we check for symmetry.
- Three, we look for damage from habits such as finger sucking and mouth breathing.
- Lastly, we check to make sure the upper permanent teeth overlap the lower permanent teeth. (No Crossbites)
A little crowding or spacing at this stage is not a cause for immediate concern or intervention.
If, any of the above four conditions have not been met, some early (Phase I) treatment may be suggested. This generally occurs between the ages of 6 and 9.
Early or Phase 1 Treatment
Early treatment could be as simple as placing a spring or wearing a retainer to move a single tooth. Sometimes widening or expanding one or more arches is necessary to make room for teeth and make the jaws match. This can involve a few fixed appliances (braces), a jaw expander and/or space maintainers. Sometimes removable orthopedic devices such as headgear or cemented appliances are utilized to help balance the skeletal structures in preparation for braces at a later date. Most of these procedures not only help with tooth positioning, but also are instrumental in normalizing muscle function; a key ingredient in favorable development of the jaws. This early treatment (necessary in about 10 to 15 percent of our patients) can span a period of a few weeks to a period of one to two years.
These are some actual photos of Drs. Grob and Donovan's Phase I treatment.