Two-Phase Orthodontic Treatment
Dentofacial orthopedics is a frequently misunderstood area of orthodontics. Dentofacial orthopedics focuses on correcting abnormalities occurring in the jaws and teeth using treatments which control the development of the patient’s facial features. Because it’s an area of medicine closely associated with still-developing facial structure, young children are ideal dentofacial orthopedic patients because their jaws and facial features are more malleable and receptive to treatments. Jaw development in children can be optimized using techniques including expansion of one or both jaws, repositioning of the lower jaw, or acceleration of the growth rate of either jaw. In teenagers and adults, dentofacial orthopedics is much more difficult to do. This is due to the fusion of growth sutures in the face and skull as we mature. It is the open and developing growth sutures that allow us to affect so much change in young growing children. Because the development of adults’ facial features is completed and the position of their jaws are set, oral surgery is sometimes necessary to treat severe problem areas in adults and create ideal jaw alignment.
Two phase orthodontic treatment is often recommended for children that have severe skeletal disharmony between the upper and lower jaws. Conditions that might warrant dentofacial orthopedics include anterior or posterior crossbites, underbites, severe openbites, deepbites, and excess anterior overjet. Early treatment can also be used to alleviate severe crowding in young patients. Generally speaking, phase-one treatment is recommended between the ages of 7 and 10, when kids still have mixed dentition (a mix of baby teeth and adult teeth). Scientific studies have shown that treating kids in this age range produces the greatest benefit for your child in the shortest amount of time. Dentofacial orthopedics is phase-one of two-phase orthodontic treatment. In young patients, during phase-one the face and jaws are brought into optimal positions using a variety of appliances that are selected based on your child’s particular needs. Later, when your child has grown all of their permanent adult teeth, we go back into phase two braces or Invisalign to align the teeth and put the finishing touches on the aesthetics and to fine-tune the bite. It is important to understand that not all kids between the ages of 7 and 10 need braces. In fact, we recommend starting Phase One treatment on only 30% of the young kids that we see for a consultation at that age. Even more important, however, is to understand that failure to identify and treat these conditions at the appropriate young age results in lots of kids needing unnecessary extractions as teenagers, or even jaw surgery as adults. For this reason the American Association of Orthodontists recommends that every child between the ages of 7 and 10 be evaluated by an orthodontist. Very often, early treatment can prevent more costly and more invasive and painful treatment in the future. Because most orthodontists offer free consultations, there really is nothing to lose by having your child evaluated early. On the other hand, waiting to have your child evaluated and treated until they are teenagers often can result in more complicated treatment (such as surgery and/or extractions of teeth) and even a compromise in the finished result because the jaws remain misaligned or poorly shaped.