Early interceptive Treatment (Phase I)

Child in BracesEarly interceptive treatment, also commonly called Phase I treatment (Phase-One treatment), may be recommended for your child.  We set limited treatment goals for early interceptive treatment and we try to keep the treatment time as short as possible.   Some children can benefit tremendously from early interceptive treatment, such as by decreasing the probability that they will need jaw surgery in the future.  There is a relatively small window of opportunity to make certain orthopedic changes to the jaws easily.  It is very important that your child is evaluated for any need for early interceptive treatment.

What Age Does a Child Receive Early Interceptive Treatment?

The American Association of Orthodontists recommends that a child be orthodontically evaluated by age 7.  Early interceptive treatment typically takes place in early mixed dentition, when there are more baby teeth than the adult teeth.  Dental development wise, I usually like to have the 4 front adult teeth in on the top and the 4 front adult teeth in on the bottom.  Age wise, my typical early interceptive patients are about 6- to 8-years-old.  However, timing is critical for early interceptive treatment and I will be evaluating the dental development, skeletal development and maturity, among other things, in assessing whether the timing is right for any early interceptive treatment for your child.  Please bring your child in for our complementary screening exam, so I can evaluate if s/he needs any early interceptive treatment.

Who Needs Early Interceptive Treatment (Phase I Treatment)?

In my opinion, most children do not need early interceptive treatment.  However, it is important to have your child be evaluated by an orthodontist, to make sure that s/he does not need early interceptive treatment. 

I recommend early interceptive treatment for any child who falls into either of the two categories below:

  • Early orthodontic treatment will result in benefits.  These benefits will be difficult to achieve (and usually more costly and/or invasive) or impossible to achieve, if the child were to wait to obtain orthodontic treatment when s/he is older. 
  • Early orthodontic treatment will result in prevention of damage or decreasing the risk of potential damage.  

Typical Cases in Which I Recommend Early Interceptive Treatment

  • Posterior crossbite
  • Anterior crossbite
  • Adult teeth are stuck somewhere (impacted) and unable to come into the mouth without orthodontic intervention
  • Severe overjet (upper front teeth stick out much much farther than the lower front teeth)
  • Severe crowding
  • Child being teased or psychologically affected, due to positioning of teeth
  • Child unable to quit oral habits (finger sucking, thumb sucking, lip sucking, etc.)

Goals of Early Interceptive Treatment

Goals of early interceptive treatment are limited.  I do not attempt to correct all the orthodontic problems at this stage because it is not possible.  Not all the adult teeth are in the mouth, so I cannot straighten all the adult teeth yet and cannot fully correct the bite.  Unfortunately, straightening out the baby teeth does not result in the adult teeth coming in straight.  It is important to understand that most patients, who received early interceptive treatment, will need another round of orthodontic treatment later (usually in the pre-teen or teen years) to address all orthodontic problems. 

What is Involved in Early Interceptive Treatment?

There are various orthodontic appliances I use, when I do early interceptive treatment, and what I recommend will mostly depend on the treatment goals.  I don’t necessarily do braces (brackets & wires) on all early interceptive patients and I may only recommend treating just the top or just the bottom jaw or teeth.  I do require that an adult brush and floss our early interceptive treatment patient’s teeth every night, so that our young patient does not end up with damaged teeth.

How Long is Early Interceptive Treatment?

This will vary depending on the patient, but it is typically 9 to 12 months in my cases. 

What Happens After Early Interceptive Treatment?

The patient will usually receive retainers or other types of appliances (either glued in the mouth or removable, depends on the patient) to wear.  The patient will come in periodically (usually every 3- to 6-months) for retainer check appointments.  During these appointments, I will check the fit of any retainers, adjust the retainers as needed, and will be monitoring the dental (and when needed, the skeletal) development.  I will also be checking to see, if the patient is ready for the next and usually final round of orthodontic treatment.  Almost every patient that received early interceptive treatment will need another round of orthodontic treatment later.  This second round of orthodontic treatment is often called Phase II treatment (Phase-Two treatment).

Phase II Treatment (Phase-Two Treatment)

Typically, phase II treatment is comprehensive orthodontic treatment with treatment goals usually addressing both bite and alignment.  Usually, all the adult teeth (except the wisdom teeth) or almost all the adult teeth are in the mouth.  Age of phase II treatment will depend on the patient’s skeletal and dental development. 

Any Questions?

Please contact our office at 619-670-4018 with any questions or to schedule your child’s free orthodontic screening exam.