What is early orthodontic treatment?
Early orthodontic treatment (Phase 1, interceptive treatment) is a limited treatment carried out while baby and permanent teeth are present together, making use of the jaws' growth potential. The aim is to prevent or reduce problems that could become more complex later, to make room for the permanent teeth and to protect the teeth from injury.
Why is the first orthodontic check-up recommended at around age 7?
By this age the first permanent molars and the front incisors have come through. The orthodontist can assess the bite, the space available and jaw development and spot any problem early. A first check-up does not mean treatment starts straight away. For most children, monitoring every 6–12 months is all that is recommended, and treatment is left for the right time.
When is early treatment considered?
- Crossbite: Especially when it causes the jaw to shift to one side
- Lower jaw protrusion and a tendency towards upper jaw retrusion
- Severe crowding: No room for the permanent teeth to come through
- Markedly protruding upper front teeth: Risk of fracture in falls and knocks
- Habit-related open bite: Thumb sucking, tongue thrust
- Early loss of baby teeth: Need for a space maintainer to prevent loss of space
- Teeth that do not erupt or erupt in the wrong direction
Methods used in early treatment
- Palatal expansion appliances
- Functional appliances
- Face mask
- Space maintainers
- Habit-breaking appliances
- Clear aligners for the mixed dentition (Invisalign First)
- Braces on a limited number of teeth
Possible benefits and limits of early treatment
| Possible benefits | Limits |
|---|---|
| Reducing some skeletal problems by guiding growth | Early treatment does not add benefit for every problem |
| Making room for the permanent teeth | A second phase may be needed once the permanent teeth are in |
| Lowering the risk of injury to protruding teeth | The child's cooperation strongly affects the outcome |
| Helping to stop habits | Total treatment time may be longer |
For this reason, the decision on early treatment weighs the expected benefit against the burden it places on the child and the family.
What happens after Phase 1?
Once Phase 1 is complete, the result is maintained with an appliance if needed and the eruption of the permanent teeth is monitored. When the permanent dentition is complete, the orthodontist assesses whether a second phase (Phase 2) is needed to fine-tune the final position of the teeth.