Early Intervention

What is Conservative Treatment for Children?

Why do the American Association of Orthodontists and the American Board of Orthodontists recommend children be evaluated by an accredited orthodontist by age 6?

It may surprise you that “Modern” Orthodontic Braces have been around since 1925 with the American Association of Orthodontists being established even earlier in 1900. Over the last hundred plus years, there have been many changes and improvements to the way Orthodontists approach treatment.

Today we know that the development of the dental arches plays a pivotal role in the eruption and alignment of teeth. We also know that the more we move a tooth, the harder it is to hold the alignment. So it should come as no surprise that we have learned to treat patients younger in the hopes of creating an environment that promotes better arch development and restores the arch width/length to an ideal size for each individual patient’s needs. When we consider we come from a mix of our parents, grandparents, etc., we can begin to see why so many kids’ tooth sizes don’t fit their jaw size and why so many upper and lower jaws don’t seem to match. Add to this outside influences such as mouth breathing (allergies), digit sucking and tongue thrust during swallowing and we realize how rare it is for everything to match perfectly.

With experience from 100 years of history and years of specialized training after dental school, an accredited Orthodontist can restore the size of the bones and modify growth such that the teeth fit into the arches better as they erupt (many times without the need to remove permanent teeth), impaction of teeth is prevented, crossbite and overjet are corrected with growth and even underbites are corrected before reaching the point of surgery.

Does this prevent the need for future braces?

Sometimes but normally once the teeth erupt there will still be minor corrections to make however tooth movements will be smaller and more stable and the overall facial profile will be greatly improved through growth. Of course not every child benefits from early interceptive treatment and even when it would be helpful, we still weigh the cost v. benefit v. what can be corrected later in a single phase. This is where opinions may differ and treatment plans may vary however significant problems seen early are almost always better treated prior to eruption of teeth; severe problems such as impaction of teeth and/or ectopic eruptions (teeth erupting outside of their normal position) can be prevented altogether. Even when a patient can be treated later with braces (perhaps with removal of permanent teeth), the future effects on the face and profile by reducing lip support or leaving the lower jaw compressed back can be dramatic.

Unfortunately, general dentists are not in tune with developmental interceptive orthodontics and they may not know what is possible through orthopedic treatments early in development. General Dentists are busy pushing the envelopes of esthetics with advanced imaging and later generation ceramics/porcelains; they don’t have time to be experts in child development. Orthodontists train for years beyond dentistry and further years in private practice while keeping up with constant changes in the literature, you simply cannot expect to wait for a referral from a general dentist when the one who in trained to recognize a problem is the Orthodontist. This is why all of the governing dental associations and boards recommend that children see an accredited Orthodontist by age 6 to screen for developing malocclusions early. The Conservative Orthodontist is no longer the doctor who waits for all teeth and treats every patient the same, the Modern Conservative Orthodontist is the one who can prevent more serious issues (impaction of teeth, extraction of permanent teeth, overjet/underbite/openbites, and even surgery) through early interceptive methods using the child’s own growth to restore the foundation for the teeth prior to their full eruptions leaving a more natural, more esthetic and more stable correction for life.

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