As pediatric dental specialists, we see parents who want the very best for their children’s health, including a healthy, confident smile. A common question we hear is about braces and when a child might need them. Many parents are surprised to learn that we can address some orthodontic issues much earlier than the teenage years. This early approach, known as Phase 1 or interceptive orthodontics, works to guide a child's developing jaw and teeth into a more favorable position.
This proactive treatment can often make future orthodontic work, like traditional braces, much simpler or, in some cases, unnecessary altogether. By intervening while the jaw is still growing, we can correct problems that would be more complex to fix later. This process involves identifying and addressing issues like crowding, crossbites, or harmful oral habits before they become more severe. The goal is to create a better environment for permanent teeth to erupt, setting the stage for a lifetime of better oral health.
What is Interceptive Orthodontics?
Interceptive orthodontics is a specialized, phased approach to orthodontic care that we provide for children who still have some baby teeth. Unlike traditional orthodontics, which typically begins when most permanent teeth are in, this early treatment focuses on the structure of the jaw and arches. We recommend an initial orthodontic evaluation around age seven. At this age, a child has a mix of baby and permanent teeth, which allows us to spot subtle problems with jaw growth and emerging teeth while the primary teeth are still in place.
The core idea is to "intercept" a developing problem, eliminate its cause, and guide the growth of the facial and jaw bones. This process helps create adequate space for incoming permanent teeth. Treatment might involve using custom oral appliances, such as palatal expanders to widen the upper jaw, space maintainers to hold space for unerupted teeth, or other devices to correct bite problems. By addressing these foundational issues early, we can often prevent more serious complications from developing later.
Addressing Jaw Growth and Alignment
One of the primary goals of early treatment is to influence jaw growth. If a child's upper or lower jaw is growing too much or not enough, it can lead to significant bite problems. For instance, a narrow upper jaw can cause crowding and lead to a crossbite, in which the upper teeth bite inside the lower teeth. Using a device like a palatal expander, we can gently widen the upper arch over several months. This correction is much easier in a young, growing child than in an adolescent or adult whose jaw bones have fused. Correcting these skeletal discrepancies early helps the jaws fit together correctly.
Creating Space for Permanent Teeth
Crowding is one of the most common reasons for orthodontic treatment. Interceptive orthodontics can help manage this issue before it becomes severe. If we determine that a child's jaw is too small to accommodate all the permanent teeth, we can use specific appliances to create or maintain space. This might involve strategically removing certain baby teeth or using space maintainers after a baby tooth is lost prematurely. By ensuring there is enough room, we can help permanent teeth erupt in an ideal position, reducing the likelihood of them becoming impacted, crooked, or misaligned. This proactive space management can significantly reduce the complexity and duration of Phase 2 treatment (traditional braces) later on.
Correcting Harmful Oral Habits
Certain habits in young children can negatively impact dental and facial development. These behaviors can alter standard jaw growth patterns and cause teeth to move into poor positions. Interceptive orthodontics provides an opportunity to address these habits and mitigate their effects before they cause lasting damage. Correcting them early can prevent the need for more extensive orthodontic treatment later.
We often work with families to help children stop habits that can lead to orthodontic problems. By identifying and managing these behaviors during a child's formative years, we can guide their dental development toward a healthier, more stable outcome. This process not only improves the alignment of their teeth but also contributes to better overall function and facial balance.
Thumb Sucking and Pacifier Use
Prolonged thumb sucking, finger sucking, or pacifier use beyond a certain age can push the front teeth forward and alter the shape of the roof of the mouth. This can lead to an "open bite," where the front upper and lower teeth do not overlap when the back teeth are closed. It can also cause a crossbite. We can provide counseling and strategies to help a child stop the habit. In persistent cases, we may recommend a fixed appliance, sometimes called a "habit breaker," that makes it uncomfortable for the child to continue the habit. This appliance is gentle and serves as a constant reminder, helping to break the cycle and allow the teeth and jaw to develop normally.
Tongue Thrusting
Tongue thrusting is the habit of pushing the tongue against the front teeth when swallowing, speaking, or at rest. Over time, this constant pressure can create an open bite or cause the front teeth to flare out. Many children outgrow this swallowing pattern, but for some, it persists. We can use specialized orthodontic appliances to help retrain the tongue to rest in its proper position at the roof of the mouth. This therapy, sometimes combined with exercises from a speech or myofunctional therapist, corrects the underlying muscle function, allowing for a more stable and lasting orthodontic result.
Simplifying Future Treatment
One of the most significant benefits of interceptive orthodontics is its ability to make future treatment—if needed at all—shorter, simpler, and more effective. By resolving major structural or alignment issues during a child’s growth phase, we lay a much better foundation for their permanent teeth. This early work can simplify a complex orthodontic case.
Even if a child still needs braces (Phase 2) during their teenage years, the duration of that treatment is often significantly reduced. For example, if we create enough space for all the permanent teeth to erupt, Phase 2 may only involve fine-tuning the alignment rather than dealing with severe crowding or extractions. In some cases where interceptive treatment successfully addresses the primary issues, a second phase of treatment may not be necessary. This step saves time and expense and reduces the amount of time a child spends in orthodontic appliances.
Reducing the Need for Extractions
Severe crowding in adolescents and adults sometimes requires the extraction of permanent teeth to create enough space to align the remaining ones. A key advantage of early interceptive treatment is that it can often prevent the need for these extractions. By expanding the arches and guiding jaw growth, we can create the necessary space for all permanent teeth to fit naturally within the dental arches. Preserving all permanent teeth is ideal for achieving a broader, fuller smile and a more balanced facial profile.
Improving Overall Outcomes
By addressing problems in two distinct phases, we can leverage a child's natural growth to achieve results that might not be possible once the face and jaws have fully developed. Correcting a severe crossbite or underbite early on not only improves function but can also enhance a child's self-esteem and confidence. Ultimately, interceptive orthodontics aims to achieve a final result that is not only beautiful but also long-term, stable, and healthy.
A Healthier Smile for the Future
Interceptive orthodontics is a powerful tool for guiding your child's dental and facial development. By identifying and addressing potential issues early, we can correct harmful habits, guide jaw growth, and create a better environment for permanent teeth. This proactive approach can simplify, or even eliminate, the need for traditional braces later on, leading to simpler treatments and better long-term outcomes. An early orthodontic screening around age seven is the best way to determine if your child could benefit from this forward-thinking care.
Frequently Asked Questions About Interceptive Orthodontics
At what age should my child have an orthodontic evaluation?
We, along with the American Association of Orthodontists, recommend that a child receive their first orthodontic screening by age seven. At this point, the first permanent molars have typically erupted, establishing the back of the bite. This examination allows us to evaluate the relationship between the jaws and screen for any developing issues, such as crowding, crossbites, or problematic oral habits, even if many baby teeth are still present.
Does every child who has interceptive orthodontics still need braces later?
Not necessarily. The primary goal of interceptive orthodontics (Phase 1) is to address significant skeletal or developmental issues. In some cases, successfully guiding jaw growth and creating enough space for permanent teeth can be sufficient to allow the teeth to erupt into a functional and aesthetic alignment. While many children will still benefit from a second phase of treatment (such as braces or aligners) to fine-tune their tooth alignment, interceptive treatment often makes this second phase much shorter and less complex. For some, Phase 1 is all the treatment they will ever need.
At ABQ Pediatric Dentistry, we are dedicated to providing comprehensive and compassionate dental care for infants, children, and teens throughout Albuquerque and the surrounding communities. We believe in building a foundation for a lifetime of healthy smiles, and we invite you to contact us to schedule a consultation and learn more about how we can support your child's oral health.