The 411 on Braces

by Dr. Brad Chvatal

As you look around at your child’s friends, you may notice some kids as young as 6 or 7 years old getting braces.  You may be wondering if your child should be getting braces, too.  Though many orthodontic problems can wait to be corrected when all the baby teeth have fallen out, there are some orthodontic problems that are better corrected when the patient is younger and can provide critical assistance to development. Delaying treatment for some orthodontic problems can lead to increased difficulty in correcting the problem, abnormal jaw growth, abnormal tooth wear or chipping, and even less stable long-term results.

Two-phase orthodontic treatment is a specialized process that combines physical and structural changes with tooth alignment. The purpose of a two-phase approach is to maximize the opportunity to accomplish the goals for health, function, and esthetics at a time when the developing structure can be more easily manipulated.

It is called a two-phase approach because it involves two separate and distinct periods when your child receives orthodontic treatment.  The early phase, or “Phase I,” usually begins when your child is between seven and ten years old, but varies because of the eruption of the teeth and growth of the patient. The main goal of the first phase is to correct structural problems, such as crossbites or underbites, and to help to make room for the permanent teeth, allowing them to grow in with less crowding and strain. Helping the jaw develop in a way that will accommodate all of the permanent teeth and improve the way the upper and lower jaws fit together during early treatment benefits children tremendously. It is one of the reasons fewer teeth are extracted for orthodontics these days compared to past years and improves the overall health of the child.

The second phase of treatment, or “Phase II,” usually begins once the permanent teeth have all erupted into the mouth, around 12 years old. This is the phase where braces are on all the teeth. The purpose of this phase is to finalize the alignment of the teeth and also the bite. The goal of the second phase is to make sure each tooth has an exact location in the mouth where it functions ideally with the lips, cheeks, tongue, and other teeth. This allows for a great smile, healthy bite, and long-term stability of the teeth, gums, and surrounding bone.

Most orthodontists offer complementary initial screenings and recommend that every seven year-old be evaluated for bite problems that need to be addressed at an early age.  While not every patient requires two phases of treatment, the orthodontist can monitor growth and development of the jaws and decide on if and when the time is right for treatment for your child.  No referral is required from your general dentist to have your child assessed and you can call an orthodontist directly. 

Your smile is your greeting to the world. It’s also a window to an important part of your dental health. The development of the smile begins well before all the permanent teeth are in place. The foundation for that smile, that health and that confidence begins early. An orthodontist is trained to recognize and treat those difficult issues before they become difficult problems.

Dr. Brad Chvatal is a board-certified orthodontist in private practice located in Eugene, Oregon.  He is Diplomate of the Board of Orthodontics, and an active member of the Angle Society of Orthodontists and American Association of Orthodontists.  He has lectured and taught courses nationally on orthodontics at OHSU, Baylor College of Dentistry, the AAO, and the Charles Tweed Foundation. He also is the father to four great children and an avid marathon runner.