Frequently Asked Questions
Q. When is the best time to refer a child with a skeletal disproportion or oral habit?
A. Because some orthodontic problems respond best to early correction, the child should be referred as soon as a problem is recognized. Optimal treatment timing will be determined by an accurate differential diagnosis and the growth and development of the individual patient.
Q. Why are some children treated before all of the permanent teeth erupt?
A. In most cases where early orthodontic treatment is recommended, the objective of interceptive treatment will be one or more of the following:
- To correct jaw disproportions before aligning the teeth.
- To prevent injury to protruded teeth.
- To manage insufficient arch length (crowding).
- To eliminate damaging habits.
For patients with these problems, timely treatment may provide advantages that are not available later. After the permanent teeth erupt, the treatment objective is to achieve optimal alignment, esthetics, function, and stability.
Q. Do all children with orthodontic problems require interceptive treatment?
A. No. The need for interceptive orthodontics must be determined on an individual basis. After a thorough diagnosis, the orthodontist will determine whether the benefits and opportunities significantly outweigh the time and effort involved in two phases of treatment. For many children, a delayed single-phase treatment is the best approach.
Q. Why are serial or selective extractions recommended for some young patients?
A. Early removal of selected primary teeth can be necessary to guide the eruption of permanent teeth. Carefully timed extractions may prevent a variety of problems, including:
- Palatal impaction or high eruption of permanent canines with little or no attached gingiva.
- Root resorption, especially on permanent laterals incisors.
- Severe crowding in the permanent dentition requiring extensive appliance therapy.
Q. Why is age 7 an ideal time for screening by an orthodontist?
A. With the presence of permanent incisors and the first molars, the orthodontist can evaluate skeletal and occlusal relationships as well as present and future crowding. Also, habit patterns, facial asymmetries and fracture-prone incisors are likely to be apparent by this age. A 7-year-old also has the available growth that may be critical to the correction of skeletal orthodontic problems.
Q. Why is the term dentofacial orthopedics used in orthodontics?
A. The objective of contemporary orthodontics is a well-proportioned face, as well as an aesthetic and stable dentition. For that reason, the orthodontist must evaluate the dental arches and face in three dimensions of space: transverse, anterior-posterior, and vertical. It is often through facial orthopedics that the orthodontist is able to achieve a treatment result with jaws in proportion to each other and to the rest of the face.