Dentofacial orthodpedics is a specific type of orthodontic treatment that is practiced by some orthodontists. Some children as early as age 5 will begin to show specific jaw growth patterns that if left untreated will prove to be detrimental to the teeth and overall oral health. Severe crowding, underbites, overbites, overjet, and other conditions due to skeletal abnormalities in a child’s facial growth can cause developmental problems at early ages and can sometimes delay or prevent proper eruption of permanent teeth, interfere with proper chewing and function, and also negatively affect speech and swallowing patterns. Failure to treat specific orthodontic conditions early can result in impacted teeth and/or a jaw discrepancy that is too severe to be corrected with braces alone and will require jaw surgery to achieve an ideal result. The benefits of this type of treatment (when indicated) include aiding in normal jaw growth and development, improvement in oral function, prevention of tooth extractions and other dental surgeries, and increased long term dental stability. Dr. Robinson does not recommend this type of treatment for all patients, but does recommend (in accordance with the American Association of Orthodontists) seeing children by age 7 for their initial orthodontic evaluation to see if they would benefit from a two-phase approach to treatment.
Phase I Treatment
Phase I treatment is the initial phase of orthodontic treatment that is performed when the child has a mixed dentition (meaning that some of the permanent teeth have erupted, but that some of the primary “baby” teeth are still present). In this phase of treatment, Dr. Robinson has the ability to use specific oral appliances such as expanders, braces, headgear, and elastics to help direct proper jaw growth or dentofacial development. The types of appliances used and treatment done vary based on the fit of the teeth and the child’s growth pattern. At the completion of Phase I, we will discontinue any active treatment and provide retainers to maintain the changes that were achieved prior to entering the resting phase.
The resting period is a time when retainers are worn to maintain the relationship of the teeth and jaws that were achieved in Phase I treatment along with monitoring and observation of dentofacial development. Dr. Robinson will see patients during the resting phase at least every 6 months to make sure that the Phase I result is stable, that the retainers are fitting properly, and that dental development is occurring normally. This phase varies in length, but typically lasts from 1.5 to 3 years. Dr. Robinson will keep a close eye on your child’s tooth and jaw development during this period and will let you know when it is an ideal time to begin Phase II treatment.
Phase II Treatment
Phase II is initiated around the time that all of the permanent teeth have erupted into the mouth. This phase typically involves braces or aligners to make sure that all the newly erupted teeth are in their proper position within the dental arches and in perfect harmony or balance with one another. At the completion of Phase II, new retainers will be made to fit over all of the teeth and maintain the result that was achieved.
Advantages of Two-Phase Orthdontic Treatment
Two-phase orthodontic treatment is a special process that encompasses tooth straightening along with physical (facial) changes. The major advantages of a two-phase approach are to maximize the opportunity to achieve dentofacial changes that will have a lasting affect on not only oral health and stability, but facial harmony and balance.
The disadvantage of waiting for complete eruption of the permanent teeth before starting any treatment and having only one phase of treatment, for someone with a jaw discrepancy, is the potential of achieving a less than ideal result that may not be as esthetic, balanced, functional, or as stable as one that could be achieved with two-phase orthodontic treatment.