The American Association of Orthodontics recommends each child have an orthodontic evaluation at age 7. There are some functional problems such as crossbites, crowding, overbites and underbites which are best addressed during growth spurts and while there is still a combination of baby and permanent teeth.

Early orthodontic treatment, if indicated, can help minimize the need for more extensive treatment at a later date, such as extraction of permanent teeth, surgical exposure of impacted teeth, and jaw surgery. In some cases, preventive or interceptive care can guide the jaws and erupting teeth into more favorable positions, improve the growth and alignment of the jaws, preserve space for the permanent teeth, and/or reduce the likelihood of fracturing protruded teeth. Treatment of certain problems at an early stage allows utilization of natural child growth and development to occur with orthodontic guidance. Furthermore, treatment of these problems at a later time can produce limited results.

The advantages of early treatment include:

• Moving the front teeth back so they will be less susceptible to injury

• Improving the relationship of upper and lower jaws, allowing more normal future growth and development

• Using maximum advantage of growth for successful treatment

• Improving facial appearance and self-esteem

• Taking advantage of the good cooperation of patients at this age

• Possibly avoiding or reducing the need for further treatment when patients are older

Seven warning signs to look for in 7-year-olds

• Do the upper teeth protrude?

• Is there a deep bite?

• Is there an underbite?

• Is there an open bite?

• Is there too little or too much room for the teeth?

• Do the front teeth line up?

• Is there a crossbite?

When early treatment is indicated, we refer to this as Two-Phase Orthodontic Treatment. A two phase treatment consists of a first phase of approximately 12-18 months of active treatment of the mixed dentition (baby and permanenet teeth both present). This is followed by an intermediate period of retainers while permanent teeth erupt. This is typically 1-2 years, depending on an individual’s growth growth rate. Patient cooperation is essential for early phase treatment!

As in single phase treatment, two phase treatment has an active treatment of 2-3 years. However, the two phases are divided into two different time periods to most effectively treat the specific problems at their optimal times. Phase two consists of the extremely important final dental and bite refinement.

Occasionally when a patient is undergoing two phase therapy, the permanent teeth erupt quicker than anticipated. If this situation should occur, the parents will be advised, and the patient will continue directly into the second phase of treatment without removing the orthodontic appliance. No intermediate period will be necessary.