The Benefits of (Early) Interceptive Orthodontic Phase 1 Treatment
This is an actual patient at High Tide Orthodontics! (She started treatment at age 8 years old)
Before Early Interceptive Phase I Treatment, notice the following:
Narrow Upper Jaw
Dental Open Bite (front teeth aren’t touching and this can lead to a “tongue thrust” habit)
Her back teeth are in dental crossbite (look at the left side of picture)
Patient had signs of Pediatric Sleep Disordered Breathing*
9 Month Later… We are finished with Phase I Interceptive Orthodontics!
Dr. Trev corrected her narrow jaw, her open bite to an ideal bite, and gave enough room for future adult tooth to grow into a better position. Even more importantly, she stopped her snoring/mouthbreathing!
Her next phase (Phase II) should be short and sweet! And she can now sleep soundly and grow/develop to her maximum potential :)
When most people think of orthodontics, they picture teenagers with braces. But did you know that orthodontic treatment can (and often should) begin much earlier? The American Association of Orthodontists recommends that children have their first orthodontic evaluation by age 7* (see “Dr. Trev’s Final Thoughts” below on this age recommendation). While this doesn’t always mean immediate treatment, it opens the door to early intervention when needed — and that can make a big difference.
Here’s a look at why early orthodontic treatment, also known as Interceptive Phase I treatment, can be beneficial and what parents need to know.
1. Guiding Jaw Growth and Development
One of the biggest advantages of early orthodontic treatment is the ability to guide the growth of a child’s jaw. The bones of the jaw are still developing in young children, which makes it easier to correct structural issues before they become more difficult (or even impossible) to fix later. The upper jaw has a suture line that becomes more fused and interdigitated (imagine a zipper that becomes more complex over time) throughout the adolescent and teen years. Once a patient is past his or her growth spurt, often the suture cannot be expanded with a simple appliance (and will need surgical intervention or a mini-implant supported skeletal expander).
For example, if a child has a crossbite, underbite, or severe crowding, early treatment can help align the jaw properly — often preventing the need for more invasive procedures like surgery or tooth extractions in the future.
2. Creating Space for Incoming Teeth
Sometimes, a child's mouth isn't big enough to accommodate all of their permanent teeth, which can lead to crowding. Early orthodontic treatment can create space by guiding tooth eruption or expanding the arches of the mouth. This proactive approach often reduces the need for more extensive treatments later on, such as tooth extractions or long-term braces.
Dr. Trev used to wait for at least the four top adult teeth and 4 back adult molars to grow in before starting Phase 1 orthodontics, but that is not a requirement anymore. Sometimes the delayed eruption is due to the adult tooth crowding… so why would we wait??
3. Airway, Pediatric Sleep Disordered Breathing, and their related developmental concerns (SUPER IMPORTANT!)
Recent research has supported improvements in the following symptoms of Pediatric Sleep Disordered Breathing (patient above had these symptoms) with expansion of a narrow upper jaw with an orthodontic expander appliance: mouthbreathing, night time grinding, snoring, irritability during daytime due to restless sleep, bedwetting. The main reason that expanders can help is because the expander widens the upper jaw which can widen the nasal airway —> leading to less resistance of airflow through the nose and better sleep at nighttime. Research is also supporting the possibility of the tonsils shrinking with early expansion (this will be another blog post soon!). However, Dr. Trev will recommend and refer to an ENT to get an evaluation (if we are starting super early orthodontic treatment due to airway concerns).
4. Improving Speech and Bite Function
Certain orthodontic issues can affect how a child speaks or how they chew food. Early treatment can address problems like open bites, overbites, or tongue thrusting, which may improve articulation and overall oral function. This can boost a child’s confidence and make everyday activities like eating and speaking more comfortable. A myofunctional therapist will be helpful part of the team in this regard, as well!
5. Boosting Self-Esteem (and Reducing Bullying)
A healthy smile contributes significantly to a child’s self-confidence. Children who are self-conscious about crooked teeth or a misaligned bite may be reluctant to smile, speak, or participate fully in social situations. Early treatment can set the stage for a more confident smile early in life.
6. Preventing More Serious Problems Later
Orthodontic issues rarely fix themselves. What might be a minor issue at age 5 could become more complex by age 12 or 13. Addressing problems early often means shorter and simpler treatment later — and in some cases, it can eliminate the need for braces in adolescence altogether.
7. Reducing the Risk of Dental Trauma
Protruding front teeth (often referred to as “buck teeth”) are more susceptible to trauma — especially in active kids. Early treatment can bring these teeth back into alignment, reducing the risk of them getting chipped or knocked out during play or sports. Dr. Trev will at least recommend a mouthguard in patients that have protruded teeth to reduce incidence of tooth fracture!
Dr. Trev’s Final Thoughts
Early orthodontic evaluations don’t always lead to immediate treatment. In many cases, the orthodontist will recommend a “watch and wait” approach, monitoring the child’s growth and development. But when treatment is needed, starting early can lead to better, more efficient outcomes — and a healthier, happier smile.
Although the AAO recommends seeing patients at age 7, Dr. Trev predicts that this recommendation will change to age 5 years old (crazy, right?). The main reasons being the following:
Dr. Trev is treating earlier to combat early crowding concerns which can lead to delayed adult tooth eruption and future adult tooth extraction/impaction risk
The upper jaw is even easier to expand at this young age (and we can use a more compact/comfortable jaw expander); also, newer research supports the stability of expanding off baby teeth with custom, 3D printed expanders
We don’t want to wait any longer if airway is already a concern (this may be the most important reason and why orthodontics will swing towards earlier treatment in most practices of the future)
Even if we see a young patient and Dr. Trev recommends the “watch and wait” approach, at least having that gameplan gives the parents peace of mind!