What is Early Treatment as You Practice It?
Funny how verbiage changes from year-to-year and generation to generation. But I can sincerely say that orthodontic treatment is an awesome option for many patients - and not that many years ago, you might have thought it odd that I would use the word, “awesome” to describe orthodontic treatment.
After all, “awesome” meant something that would induce an overwhelming feeling of awe, like seeing Michelangelo’s ‘David’, carved from one piece of stone, in all its detail, or seeing the immensity of the Grand Canyon.
Today, “awesome” is used to describe things that we like. Orthodontic treatment might be called awesome, when we mean pretty great, OR when we mean it induces true awe in its results.
At what age or stage of development do I recommend Early Orthodontic Treatment?
Another term that has changed is, “Early Treatment.”
Not that many years ago, again, “Early” treatment meant treatment of a nine, or ten-year old patient. Now, “Early” treatment may mean treatment of a twelve-month old Class III patient.
As the evolution has occurred, of orthodontic treatment by generalists, the “gate-keepers” of comprehensive dental care, (including our modern terms, the “GP”, and the “Pediatric Dentist") the meaning of “Early Treatment” has broadened. This has meant a broadening of possibility for the child patient and for his or her parents.
This expansion of treatment possibilities provides opportunity for beauty and lifetime function that can only be called awesome - in every sense of the word. Now, Pediatric Orthodontics brings miraculous and amazing possibility to the child patient and his parents.
What are the benefits of providing Early Orthodontic Treatment?
In pediatric residencies around the country, young doctors learn the term, “FLK”. That is a descriptive acronym, standing for, “Funny Looking Kid.” We can now offer children the opportunity for early esthetic changes that erase the risk of being an “FLK”.
A thumb-sucker who otherwise may suffer from a distorted maxilla and mandible, openbite and protruding tongue can be treated as soon as the two-year molars are erupted, not having to grow up as a FLK and have dental compensation treatment provided in the difficult middle school years.
A Class III infant can be treated at around age 12 months, and avoid being thought of as “tough”, as a “bully”, and not be teased.
A Class II child with severe protrusion can avoid having repetitive trauma to the protrusive incisors, with fractures, and need for root canal treatments, barely after the permanent incisors have erupted at age seven or so, and then future crowns being done and redone.
A child with crowded incisors can have much more stable alignment of those incisors when treatment is begun before the teeth have completely erupted and connective tissues formed to hold them in rotated and unattractive positions.
Can you imagine, less relapse? Can you imagine a child not being teased by other children, “Why do you have so many teeth? They are ugly!”
Traditional orthodontics at age 11 - 13 is “Late” treatment.
Most any child with adverse growth - growth that is off the normal - can benefit immensely from treatment to direct and redirect growth toward the normal. And, many children and their parents can rejoice in “Phase I and done” - orthodontic treatment in the mixed dentition, when the permanent incisors and molars have erupted. The bite can be corrected, the tooth alignment can be made beautiful, and the space can be created in the upper and lower jaws to allow the remaining teeth to erupt without problems. Phase I and done can happen with a knowledgeable pediatric orthodontist, in more than 50 percent of children.
There are children who will need a second phase of treatment because of severely ectopic - out-of-place - erupting teeth, or because of adversities like tongue position, severe trauma, extra teeth or missing teeth. For those children, the Phase I treatment will reduce the length and complexity of Phase II treatment, will reduce the need for permanent teeth extractions, and will improve the view the child has of himself - and the view others - peers, teachers, coaches, and other parents - have of the child.
The Phase I treatment will reduce the need and risk of need for surgeries later. Phase I treatment provides more stability, and less need for compensation - moving teeth around to hide the FLK face. The Phase I treatment will reduce the need for the child to adapt to less-than-ideal growth, less-than-ideal bites, and less-than-ideal esthetics.
What would you say to a Pediatric Dentist who is reluctant to do Early Orthodontic Treatment?
While we are considering terms and the changing meanings of terms, let us consider that “Early” treatment is NOT a great term, as it may imply, “too early.”
Traditional orthodontics at age 11 - 13 is “Late” treatment.
Yet, let us not label "Late" treatment as negative, either. Let us expand our views of orthodontic and orthopedic treatment to celebrate Interception Orthodontics (iOrtho™) which transforms smiles and lives as early as possible.
Interception Orthodontics is available and prudent as early as possible, and feasible. Let us give our child patients a beautiful self-view, give their parents the most beautiful children, make it easier for the patient and parent because the younger a child, the better the compliance. Let us reduce the need for permanent teeth extractions and surgeries, provide more stability, have growth follow our treatment as guide, and help our patients need less compensation and less adaptation. And, let us create healthy occlusions for lifetimes.
What Early Treatment protocols do you routinely use?
Bottom line - treat as early as it is possible -and feasible - to redirect and harness growth, to provide child patients a beautiful self-view, provide their parents the most beautiful children, make it easier for the patient and parent through the compliance of the young child, to reduce the need for permanent teeth extractions, for surgeries, and for compensation treatments, to provide more stability and the healthiest occlusions possible for lifetimes.
Dr Chris Baker
Dr. Chris Baker is Past President of the American Orthodontic Society, a pediatric dentist and teacher of orthodontics, An author, dental practice consultant, mentor, and a current or former faculty member of three U.S. dental schools, Dr Chris is based in glorious Texas, USA. but lectures around the world.
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© 2019 Dr Chris Baker