Phase 1, Early or Interceptive Treatment?
I hear these 3 terms all the time when it comes to kids’ orthodontics. All three approaches share a common goal: addressing problems early to set the foundation for healthier smiles and reducing the risk of needing complex treatment later in life. So, lets dive into this and get you the answers you are looking for.
How Do I Know My Child Needs Orthodontic Treatment?
Identifying and treating dental problems early, between ages 6-9, is crucial! This is a GOLDEN WINDOW of opportunity that, if missed, will unavoidably lead to the need for longer, more complex and more painful treatment if you are too late. But, determining whether your child needs orthodontic treatment can sometimes be tricky, especially since the signs of dental and bite problems aren’t always immediately obvious. However, there are several indicators that may suggest it is time for a visit to the orthodontist. We at Stellar Smiles Ortho love making things easy! So, we put together the 14 most common problems that Dr. J has encountered in his over 25 years of practicing pediatric orthodontics, and you will see our actual patients.
And, the good news is there’s a new way to address these issues that eliminates the challenges of traditional methods, virtually wipes out pain, and cuts total treatment time in half. Keep reading to discover this groundbreaking solution!
1. Buck Teeth
[Teeth that really stick out, sometimes even if the lips are closed]
Why This Occurs: Genetics, sucking the thumb or using a pacifier for long periods can affect the alignment of your child’s mouth
Problems It Causes:
- Your child will struggle to close their mouth, causing mouth breathing, dry gums, and cavities
- Difficulty eating due to misaligned teeth, often leading to indigestion
- Teeth are prone to breaking from falls or hits to the mouth
IF NO Treatment: Extractions + Surgery
2. Front Open Bite
[Big gap between Upper and Lower teeth even when biting down]
Why This Occurs: Genetics, thumb sucking where the thumb is molding the jaw bone causing permanent damage if not addressed
Problems It Causes:
- Thumb forces the tongue back and down blocking the airway affecting breathing
- The gap between the Upper and Lower teeth does not allow a proper seal causing speech problems
- Inability to eat certain foods
IF NO Treatment: Extractions + Surgery
3. Front Open Bite + Tongue Thrust
[Big gap between Upper and Lower teeth even when biting down with the tongue resting in the space]
Why This Occurs: The tongue pushing on the front of the mouth causing the teeth to give way, out and up
Problems It Causes:
- The tongue will mold the upper and lower jaws and push the teeth out of the way creating permanent damage
- The tongue is constantly pushing the teeth leading to eventual increased mobility and possible tooth loss
- The front gap between the upper and lower teeth creates a space that has to be filled to swallow and speak, causing lisps
IF NO Treatment: Extractions + Surgery
4. Underbite
[When the lower jaw is sticking out ahead of the upper jaw]
Why This Occurs: Primarily caused by genetics, but thumb-sucking, pacifier use after age 4, and tongue thrust can contribute
Problems It Causes:
- Increased uneven wear and tear of teeth
- Difficulty in eating, many times leading to indigestion
- Low self-esteem may lead to depression, anxiety, and poor learning
IF NO Treatment: Extractions + Surgery
5. Imbalance of the Face
[Jaw misalignment]
Why This Occurs: Primarily caused by genetics, expressed by uneven growth of the upper and lower jaws
Problems It Causes:
- Increased uneven wear and tear of teeth
- Low self-esteem that may lead to depression, anxiety, and poor learning
- TMJ causing teeth grinding, jaw injuries, eventual arthritis
IF NO Treatment: Extractions + Surgery
6. Deep Bite
[The upper teeth completely cover the lower teeth]
Why This Occurs: When the lower jaw (or mandible) is small. Genetics are a large factor
Problems It Causes:
- Difficulty eating and chewing, often leading to indigestion
- The tongue cannot work with the teeth properly leading to speech problems
- Upper and lower teeth are “locked” in position leading to possible jaw problems and headaches
IF NO Treatment: Extractions + Surgery
7. Thick Frenum Between Teeth
[Front teeth spread out with a lot of thick gum in-between]
Why This Occurs: Genetics can cause the frenum or lips to pull on the gums around the teeth causing recession, exposing the root of the teeth
Problems It Causes:
- The gap between teeth causes speech problems and impediments
- The frenum if stretched can tear
- Interferes with the proper growth and development of the teeth in the area
IF NO Treatment: Gum Recession, Large Gaps
8. CrossBite Back Teeth
[Teeth that rest to either side of the adjacent teeth]
Why This Occurs: Uneven growth of the upper and lower jaws
Problems It Causes:
- Can lead to facial deformity with TMJ issues
- Increased uneven wear and tear of teeth
- The upper and lower teeth are “locked” causing potential jaw problems and headaches
- Interferes with the proper growth and development
IF NO Treatment: Extractions, Surgery, Tooth Wear
9. CrossBite Front Teeth
[Teeth that are pushed and locked in the wrong position]
Why This Occurs: Uneven growth of the upper and lower jaws, genetics, chewing on nails or pencils
Problems It Causes:
- Trauma to teeth when biting down can lead to cracks and breaks
- Premature and uneven tooth wear can lead to facial deformity with TMJ issues
- Much harder to keep clean leading to cavities and periodontal disease
IF NO Treatment: Extractions, Gum Graft Surgery
10. Overcrowding
[Teeth unable to grow straight due to a lack of space in the mouth]
Why This Occurs: This can happen when a child's permanent teeth start to erupt and there isn't enough room for them to develop
Problems It Causes:
- Much harder to keep clean leading to cavities and periodontal disease
- Adult teeth can keep growing in the bone and cause severe damage to the roots of other teeth
- Difficulty eating, many times leading to indigestion
- Low self-esteem
IF NO Treatment: Extractions + Surgery
11. Baby Teeth Not Falling Out
[Narrow or small jaws not allowing space for adult teeth to grow in]
Why This Occurs: Genetics play a role in the small jaws and narrowness, Bad habits like thumb sucking and tongue position are factors
Problems It Causes:
- Forces the adult teeth to push and cause damage to other permanent teeth
- Affects facial development
- Difficulty chewing due to lack of teeth, leading to indigestion
IF NO Treatment: Extractions + Surgery
12. Premature Gum Recession
[Teeth becoming further exposed as gums drop lower]
Why This Occurs: Teeth being pushed outside normal boundaries
Problems It Causes:
- Teeth can be pushed in the wrong place causing them to be forced outside the bone
- Recession is the result of a tooth losing bone and gum
IF NO Treatment: Gum Graft Surgery, Tooth Loss
13. Hidden Blocked Teeth
[Teeth and bite look fine from the outside but severe crowding can only be diagnosed with an x-ray]
Why This Occurs: Mostly caused by genetics or habits such as thumb sucking, extended pacifier use and mouth breathing
Problems It Causes:
- Severe crowding with permanent teeth that are pushing on other permanent teeth causing damage
- No eruption or eruption of teeth in the wrong place affects facial development
IF NO Treatment: Extractions + Surgery
14. Thumb/finger Sucking Habits
[When a child has his thumb/thumbs/fingers in their mouth for extended periods]
Why This Occurs: As a self-soothing mechanism making them feel secure and comforted
Problems It Causes:
- Thumb forces the tongue back and down blocking the airway affecting breathing
- The gap between the Upper and Lower teeth does not allow a proper seal causing speech problems
- Inability to eat certain foods using the front cutting teeth (like Pizza)
- The open front gap promotes tongue thrust habit
IF NO Treatment: Extractions + Surgery
Why is It Called Phase I?
Phase I treatment is a type of early orthodontic intervention that typically occurs between the ages of 6 and 9, when a child’s permanent teeth are beginning to emerge. It is called Phase I as there is an assumption that there will be a Phase II – around the age of 12 – when all the adult teeth have erupted. As an Orthodontist practicing for over 25 years – I disagree with the term “Phase I”. If you intercept the problem early with correct orthodontic treatment there should either be no Phase II or a quick, simple treatment later on; no full-blown braces at age 12. Yes, no one can control if the teeth grow in twisted even though the bite is correct. But the solid bite foundation has been set at ages 6-9 so there should be no big surprises later on.
Why is It Called Early Treatment?
By addressing these issues early on, this treatment can help reduce the need for more complex orthodontic procedures later. But again, I think this term is not very accurate. When someone is “early” for an appointment, that’s good, but they still have to wait. So early is ok, but wouldn’t “right-on-time” orthodontic treatment be so much better and appropriate?
Why is It Called Interceptive Orthodontic Treatment?
This to me is an accurate term and describes exactly the WHY we are doing treatment. If you have seen the above multiple patient examples and the option of doing nothing this will make sense: We intercept moderate to severe bites and misaligned teeth problems that will definitely create severe to very severe problems later on, such as extractions, surgery and compromised outcomes resulting in more pain, time and money.
- Do we intercept extractions later on? YES
- Do we intercept jaw surgery later on? YES
- Do we intercept impacted (stuck to the bone teeth) later on? YES
- Do we intercept bad bites caused by habits later on? YES
How Long Does Interceptive Orthodontic Treatment Take?
Interceptive Orthodontic Treatment take Phase I treatment typically lasts between 6 to 18 months. The exact duration will depend on the nature of the problem being treated and how your child’s teeth and jaws respond to the treatment.
How is Interceptive Orthodontic Treatment done?
Based always on the severity, type, child’s age and any habits we can decide on how to treat accordingly, with the least time, effort and pain to your child. There are 3 ways:
- Traditional Treatment Combination: involves a combination of braces and appliances such as expanders, headgear, facemask, bite plate, tongue tamers just to name a few.
- Traditional Treatment Appliance only: Appliances such as expanders, headgear, facemask, bite plate, tongue tamers just to name a few.
- Invisalign® For Kids: A game changing type of treatment that is more efficient, faster, almost pain-free with less office visits. Check out our actual patients with actual amazing results.
What happens after treatment is complete?
As in all orthodontic treatment you want to preserve what you have accomplished. The way to do that is to hold the bite and teeth in the new corrected position with a RETAINER. This retainer will hold everything together for about 4-8 months. Please remember Interceptive Orthodontic Treatment takes place when your child has a mix of baby and adult teeth. So, the adult teeth, after treatment, will start growing in and they will eventually push the retainer so it will not fit anymore. But that is totally ok as explained above.
Also, after Interceptive Orthodontic Treatment is complete we will continue to see you child approximately every 6 months for an OBSERVATION/RECALL visit. At these visits we will observe the bite and how it’s holding up, any baby teeth that fell out, any adult teeth that grew in and the overall growth of the mouth. We may take a Panoramic x-ray to make sure the teeth are growing in the right direction and place.
What is the Cost of Interceptive Orthodontic Treatment and Will Insurance Cover It?
The cost of Interceptive Orthodontic Treatment, whether you choose Traditional or Invisalign® For Kids is similar. We want you to not have any barriers to get your child a healthy, functional smile. We will work with you to create a plan that fits your budget and will explain everything to you prior to any treatment.
Many dental insurance plans provide some or full coverage but it’s important to check with your insurance provider to understand the specifics of your plan. We will help you navigate your insurance, costs and payment options.
Don’t Wait!
Come see us at age 6 and get a free evaluation. You could save time, money and pain – waiting till your child loses all their baby teeth around age 12 is too late many times.
Let’s make sure your child’s smile is on the right track—and do it with as little stress as possible.