The Young and the Braceless? Not Anymore by Elvira Maricic Is younger better when it comes to orthodontic treatment for your child? print article      send to a friend

The Cornells are part of a growing number of families selecting the two-phase orthodontic approach over the traditional method. But what, exactly, does it involve, and is it the right option for your child?

An Early Start

When it comes to orthodontic treatment, there are two different ways to approach it, says George Souris, DS, MSD, a Cleveland, Ohio, orthodontist.  "There are children that come at an adolescent age and they're approached with a one-time, two-year traditional treatment that people are used to hearing about. The way a lot of children are getting treated now is that we're doing an early phase of correcting the jaw when they're younger, when they're seven or eight years old, which is really the optimal time to have your child evaluated by an orthodontist," he says.

Dr. Souris says that at this age, what he's trying to establish is twofold. First, whether there is enough room in the mouth for all the teeth to fit, and second, whether the child's jaws are properly sized and positioned. "If we have big problems in either area we want to solve them at a very young age while they're actively growing," he says. "Growth is the main reason for treating early. There is a lot of growth taking place when the kids are young, and you can take jaws that are out of position or that are too small and resize them and put them in the right spot very easily."

That's not the way it was always done, says Dr. Souris, noting that orthodontists would put off treatment until children were older. However, that has its downside, he notes. "At that point the growth of the jaw is very slow and you really can't do nearly as much with the jaws as you can when they are younger.  Because we waited until the growth was at a much slower pace, things that could have been made much easier had they been taken care of when [children] were younger were left alone. Consequently, these children end up coming for the traditional treatment at ages 15 and 16, and we ended up with a mess on our hands, trying to treat these things without a lot of growth. We ended up doing a lot of tooth pulling and a lot of long, hard treatments.

In his practice, Dr. Souris uses the two-phase approach, which includes about a year of jaw correction for his seven, eight, and nine year-old-patients. "This doesn't involve a full set of braces like you would see on a teenager," he says. "It really involves appliances, to widen jaws and fix jaws, and just a few braces on the front four teeth to get those teeth in place so that the other teeth can come in properly."

When the first phase of treatment is complete, children may still have anywhere between 9 to 12 baby teeth to lose, according to Dr. Souris. "We let them go, their face looks great, the teeth will fit, and [over the next one to three years] they lose all their baby teeth." During this process, Dr. Souris checks on them every four months. Then when they're about 11 or 12 and their permanent teeth are in, they have braces put on again to straighten the teeth. "This only takes a year, says Dr. Souris. "You can take a potentially difficult three- to four-year treatment and turn it into a simple two-year treatment by doing the jaw correcting and jaw fixing part when they're younger."

A Different POV

However, not all dentists agree that early treatment is advisable in all situations. In the March/April 1997 issue of Pediatric Dentistry (the journal of the American Academy of Pediatric Dentistry), Peter Ngan, DMD and Henry K. Fields, DDS, MS, MSD reviewed the multifactorial causes of open bite and suggested that if treatment is initiated without properly identifying the cause, recurrence is likely. Given the prevalence of open bite and the effectiveness of habit-control strategies, researchers believe further studies are needed to determine whether early initiated, lengthy treatment plans are cost-effective.

This doesn't phase Kevin Cornell, who is sure he did the right thing by starting early treatment for Anthony. "I thought it made sense because they were fixing the problem before it became permanent, and this may prevent many of the defects they may have had to fix later on. Plus, this method is less invasive and Anthony won't have to have any of his permanent teeth removed," he adds.