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You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

• Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

• Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

• Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Kevin Mancini at our Hampstead, NC and Jacksonville, NC office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

The term malocclusion refers to misalignment of teeth. You may have been born with malocclusion, so your teeth simply grew in crooked, or the misalignment and crowding of your teeth occurred over a period of time. Either way, not only can malocclusion pose cosmetic issues, but it can have a negative effect on your speaking and eating abilities as well.

Types of Malocclusion

Malocclusion encompasses multiple types and classifications of misalignment issues, including twisting or rotation of the teeth and molars that do not meet when you bite down. In some cases, the top front teeth are pushed outward in an upper protrusion.

In other cases, a misplaced midline results when the front top teeth don’t meet with the front bottom teeth. Transposition occurs when teeth protrude through the gums in a position where another tooth is supposed to be.

Practically any type of crowding or spacing issues, rotation or twisting of the teeth, or bite problem – including overbite, underbite, open bite, or crossbite – is included under the umbrella of malocclusion.

Malocclusion Classifications

There are three classifications of bite or misalignment problem.

• Class 1 malocclusion: While the bite may be normal, the upper teeth overlap the lower teeth slightly. This is the most common type.

• Class 2 malocclusion: Known as overbite or retrognathism, class 2 involves a severe overlap of the upper teeth and jaw over the bottom teeth and jaw.

• Class 3 malocclusion: Known as underbite or prognathism, class 3 occurs when the lower teeth and jaw overlap the upper teeth and jaw. Thus, the lower jaw juts forward.

Causes of Malocclusion

The most common cause of malocclusion is genetics. However, there may be other causes, including the development of abnormally-shaped teeth, lost teeth, or impacted teeth; thumb sucking or overuse of a pacifier as a small child; having fillings or crowns that do not fit correctly; a serious injury that causes misalignment of the jaw; or developing a tumor of the mouth or jaw.

Treating Malocclusion

Orthodontic care at Mancini Orthodontics with Dr. Kevin Mancini is the main treatment available for malocclusion, which includes getting braces, Invisalign, or other corrective treatments. Treatment is ideal not just to have your smile improved, but because it makes the teeth easier to clean and maintain, lowers the risk of gum disease and tooth decay, and can even take pressure off the jaw and teeth.

Think about orthodontic treatment if you (or your child) display any signs of malocclusion. Early treatment of malocclusion during childhood can lessen expensive treatment later on.

How long? Well, a beautiful smile is both science and art—proper teeth and jaw alignment united with aesthetically pleasing results. Orthodontists achieve both these outcomes with a careful analysis of any dental and facial problems, a treatment plan designed specifically for each patient’s needs, and adjustments through each phase of treatment to carefully bring about that beautiful smile.

And that’s a long way of saying, there’s no one, standard answer as to how long a patient will wear braces because there is no one, standard patient. Often, treatment takes from 18 to 24 months, but it can be months shorter or months longer depending on a variety of different circumstances.

• Different Needs

Your orthodontic needs and goals will generally determine your treatment time. Some patients need only a bit of alignment, which can lead to a fairly short orthodontic experience. Some have malocclusions such as crossbites and open bites that require more complex and lengthy treatment.

And, while we used to think of orthodontics as a teenage rite of passage, that’s certainly no longer the case. Some children will need two-phase orthodontic treatment, where early procedures before the adult teeth even come in ease the way for any necessary second stage treatment when the permanent teeth arrive years later. And some adults will want orthodontic work later in life, where denser bone tissue might lead to (somewhat) longer treatment.

• Different Appliances

Today’s orthodontics offers you many choices in appliances. Lingual braces are an almost invisible option, with brackets and wires on the inside of the teeth. Aligners use clear, custom molded trays to move the teeth into a better position with each new tray. Even traditional braces are smaller and sleeker today, with metal or less visible ceramic brackets. Depending on the orthodontic goals you want to achieve, there might be a small difference in the amount of time each appliance will take to get you to those goals. Talk to us about all your options and what they mean for treatment time.

• Different Levels of Participation in the Process

This is one area you can make a real difference! If you follow our instructions for using your appliances most effectively, you’ll make progress as quickly as possible. If you have aligner trays, be sure to wear them for as long as directed each day. If you have rubber bands attached to brackets on your upper and lower teeth, wear them for as many hours as required, because these little bands are actually the tools that are moving your teeth into alignment. If you don’t wear your braces or aligners as directed, not much is going to happen, and certainly not on schedule.

Give our Hampstead, NC and Jacksonville, NC office a call, and we can discuss your goals for creating your very best smile. Once we’ve decided on a treatment plan, Dr. Kevin Mancini can give you a fairly good estimate as to how long your particular treatment will take. And, when you get to share that beautiful, healthy smile, the time you’ve spent achieving it will be well worth it!

Perhaps you are already planning for the years when your teenager will need orthodontic work. But hearing that your seven-year-old would benefit from orthodontic treatment? That might come as a complete surprise! It’s a recommendation with real benefits, though—early intervention can save children from tooth and bite problems now, and even simplify their future orthodontic care.

Treating young children for orthodontic problems is called “interceptive orthodontics.” When the permanent teeth start arriving, there might be problems with spacing, bite or protruding teeth. Often, treatment while the bones are still growing is the best way to prevent more serious problems later.

We recommend that your child have an orthodontic consultation with Dr. Kevin Mancini around the age of seven. This exam is especially important for children who may have been thumb suckers or used a pacifier after the age of three, or if you notice obvious teeth, speech or bite issues.

• Crowding and Spacing Issues

Teeth are arranged in two crescent shapes called arches. When the arch of your child’s mouth is small, the permanent teeth can become very crowded as they erupt. Formerly, teeth were removed to make more room. Now, early use of a palatal expander can enlarge the upper dental arch in order to help the permanent teeth come in without crowding. The need for future tooth extraction is reduced, and there is a better chance for correct spacing and alignment with early treatment.

On the other hand, when a child loses a tooth too soon, too much space left between baby teeth can also be a problem. The remaining teeth can shift, leaving the wrong place open for the adult tooth to come in. We might recommend a space maintainer so that there is no shifting of the teeth and there is room for the proper adult tooth to erupt in its proper spot.

• Malocclusions (Bite Problems)

Some malocclusions, like a crossbite, can be caused by problems with jaw and facial structure. Again, we might recommend a palatal expander to help the upper arch of the teeth to fit properly with the lower jaw. Problems with overbite, open bite and other bite issues can also be addressed at this age if necessary. Early care can discourage TMJ (temporomandibular joint) disorders, reduce speech problems, and improve facial symmetry. 

• Protruding Front Teeth

Teeth that protrude are much more likely to be damaged when playing or after a fall. Methods such as braces or appliances can reposition them and protect them from breaking or fracturing.

Many children will not need early intervention, and many can wait until they are older for orthodontic work. But if your young child has orthodontic problems that should be addressed, early intervention can do more than set the stage for successful orthodontics in the teen years. Talk to our Hampstead, NC and Jacksonville, NC team about what we can do for your child. Interceptive orthodontics can protect teeth, guide jaw and speech development, modify harmful oral habits and help to adjust bite problems before they become serious—when it comes to your child’s dental health, the best solutions are early ones!