The basic objective in treating young children is to create the best environment possible for proper development of the dento-facial complex as a whole.
The recommended age to see us is 7 years old. Although we hardly ever treat comprehensively at this age, oftentimes we will recognize problems early and may intervene with minimally invasive therapy designed to encourage the proper environment. Achieving this goal leads to less severe problems or may even eliminating problems later. Usually this “early treatment” involves orthopedics, modifying bone development irregularities that are much easier to correct while the patient is still growing.
Essentially, the older one gets, the more difficult orthopedic modification becomes, until a point where it practically can not be done at all. This point usually occurs some time in mid-adolescence. While the bones are still “malleable”, we can use simple appliances efficiently and painlessly to manipulate the bones (e.g. maxillary expanders “spreaders”) or functional appliances (e.g. bionator, herbst) that change directions of growth.
Sometimes, treatment only involves minor tooth movement to eliminate a cross-bite or space maintenance such as when a primary (baby) tooth is lost early from a cavity or trauma. In severe crowding cases where there is a discrepancy of tooth structure to available bone, space management is very important. Occasionally, judicious removal of primary teeth (or more rarely permanent teeth) is necessary to obtain the favorable environment for development. Since the resorption of primary teeth and remaining space available are factors that guide the eruption of permanent teeth, deviations from normal may cause impactions, ectopic (malpositioned) eruptions, and eventual malocclusions. Sometimes these impactions or ectopic eruptions can cause loss of permanent teeth, reinforcing the need for early interception. Although most bone development problems (and their subsequent tooth position issues) are genetic, environmental factors (such as a habit, e.g. thumb sucking) can also cause them. We can help here as well with treatments the can eliminate such habits, and provide a favorable correction.