When is the right time to bring my child in for their first consultation?
Dental crossbite exhibited in a patient (age 8)
What age should we start considering an orthodontic consultation for my child? The American Association of Orthodontists recommends that all children get a checkup with an orthodontist no later than 7 years old. Dr. Trev agrees, as this is the best age to detect whether there are disturbances in jaw growth or tooth development that are more easily addressed during an earlier stage of skeletal growth.
There are generally three outcomes of an initial check-up with Dr. Trev:
No treatment is necessary.
Treatment may be needed in the future, so the child will be followed periodically while the face and jaws continue to grow. (This is the most common result from age 6 - 9 ; Dr. Trev will see the patient every 6-12 months as we monitor facial growth/tooth development to help determine best time to start comprehensive treatment).
There is a problem that lends itself to early treatment (ALSO REFERRED TO AS “PHASE 1 INTERCEPTIVE TREATMENT”)
What can parents expect at this first visit for their child?
Introduction to the High Tide team and quick tour of the office
High quality photos taken of patient’s teeth, bite and related soft tissue
Low dose CBCT (3D) x-ray for high quality facial growth analysis and teeth development/eruption
Chairside examination of teeth and bite with Dr. Trev (in consult room)
Treatment plan or recommendation by Dr. Trev
Ok, Dr. Trev just recommended Phase 1 treatment for my child… What exactly is Phase 1 Interceptive Treatment?! Phase 1 orthodontic treatment, or interceptive orthodontics, typically occurs between 6 and 9 years of age, (during the mixed dentition phase-when patients begin to lose their baby teeth, but still have a few adult teeth remaining). Regardless of how treatment goals are reached, the bottom line is that some orthodontic problems (especially of the skeletal nature) may be easier to correct if they are found and treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.
Problems seen by Dr. Trev at the consultation that would warrant a conversation about Phase 1 include the following:
Significant crowding and misalignment (Dr. Trev will analyze 3D x-ray and decide if permanent teeth have enough room to erupt into position properly)
The early loss of baby teeth due to injury or decay (can cause shifting of adjacent teeth and loss of space for future, erupting teeth)
Front teeth that are flared excessively and susceptible to injury
Skeletal growth discrepancies (narrow upper jaw, underbite, open bite due to thumbsucking or finger habit)
Goals of Phase 1 treatment are:
Help avoid the need for adult tooth extractions or jaw surgery
Make space for the grown-up teeth to come in straight and to help prevent permanent teeth from getting impacted
Make future treatment, if necessary, easier to manage, shorter in duration with better results
Alleviate problems with chewing and speaking
Boost kid'‘s confidence and self-esteem
Improve airway and associated sleep disorders (usually palatal expander in conjunction with a sleep study and myofunctional therapy)
This phase of treatment typically lasts from 8 to 12 months, and although treatment is individualized for each patient, common orthodontic therapies used at High Tide include:
3D printed RPE (rapid palate expander)
no spacers are needed anymore!
Limited braces or Invisalign (YES, WE DO PHASE 1 INVISALIGN!)
Space Maintainer (if early loss of baby teeth)
Retainers to keep expansion and teeth corrected until second phase of treatment
Important to know: Dr. Trev is proactive, but still conservative, about early orthodontic treatment. The main goal of this consultation is to educate parents about the treatment findings and associated treatment recommendations. If Phase 1 is a serious consideration, Dr. Trev will explain all the advantages/disadvantages of Phase 1 treatment vs. waiting for comprehensive phase at a later age. Dr. Trev loves to follow up with a virtual recap of the visit in case both parents aren’t able to be at the consultation.
Same patient as above, but after skeletal expansion and correction of dental crossbite