St-Sauveur
Le Plateau
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Orthodontics for children (interceptive)

Definition

The Canadian Association of Orthodontists (CAO) and the American Association of Orthodontists (AAO) recommend that all children receive their first orthodontic evaluation as early as 6 or 7 years of age, as it is around this age that the first permanent molars erupt and establish the posterior occlusion. By this time, it’s already possible to assess the relationship between teeth and jaws in 3 dimensions (front-back, width and height), and to detect many dental and skeletal problems, as well as functional deviations of the lower jaw.

Taking a panoramic radiograph around this age can reveal a great deal about a child’s “dental future” and developing occlusion. Early assessment does not imply the need for early intervention, but for some children, timely assessment can lead to significant improvements if orthodontic intervention is indicated, while for others, the immediate benefit of early assessment will promote parental peace of mind.

  • Misalignment between the lower (mandible) and upper (maxilla) jaws;
  • Malocclusion;
  • Migration of teeth after loss of milk teeth;
  • Narrow dental arches;
  • Severe malposition.

Indications for treatment

  • An orthodontic consultation at an early age can help identify specific problems: overlapping, tooth rotation, closed bite (too much vertical overhang between teeth), anterior hollowness, certain habits and facial asymmetries;
  • A  palatal expansion can be planned to widen a narrow palate or upper jaw;
  • Finger or thumb sucking habits can be monitored;
  • The use of an oral screen to try and stop an infantile or atypical swallowing habit may be prescribed;
  • The orthodontist can perform selective extractions to help the eruption of permanent teeth;
  • Correction of an anterior or posterior crossbite can be considered;
  • An orthodontic assessment at an early age is unlikely to avoid the need for further intervention later on, but it can lead to simpler, more effective treatment for patients while reassuring them about their dental condition;
  • Many intervention and interception procedures can be undertaken at an early age, which can help minimize the severity of developing problems;
  • Only the most severe problems will present indications for early orthodontic intervention.

Advantages

  • Favourably influence jaw growth;
  • Balance the width of the dental arches;
  • Improve eruption patterns;
  • Reduce the risk of trauma to protrusive upper incisors;
  • Correct oral habits;
  • Improve aesthetics and self-confidence;
  • Simplify and/or shorten the duration of subsequent corrective orthodontic treatment;
  • Minimize the possibility of permanent teeth becoming impacted;
  • Improve certain speech problems;
  • Preserve or recover the space needed for the eruption of permanent teeth.

Risks and consequences of not treating

  • Extraction of one or more permanent teeth;
  • Permanent teeth included;
  • Severe malocclusion;
  • Temporomandibular joint (TMJ) dysfunction.

Processing steps and times

  • At the initial assessment, if nothing major or abnormal requiring intervention is detected, the child will be placed under “observation” and re-evaluated at regular intervals from 12 to 18 months to follow the evolution of his or her dentition;
  • Appropriate recommendations will be made in due course at subsequent visits;
  • In patients with mixed dentition (presence of temporary and permanent teeth), nature must be left to act between each examination and intervention (if intervention is required);
  • It’s usually sufficient to reassess dentition development every year. There is no advantage to seeing patients more frequently unless a particular condition needs to be monitored more closely.

The dentist may also recommend a panoramic X-ray to :

  • Get an overview of the developing dentition;
  • Follow the development and eruption of the dentition;
  • Ensure that all teeth are present and developing normally;
  • Evaluate the direction of eruption of teeth and the space available for them to emerge in the mouth;
  • Help anticipate and minimize the onset of certain problems.

Cost

Costs vary according to the complexity of the problem to be corrected.

Maintenance

  • Maintaining good oral hygiene is essential throughout treatment, as wearing braces encourages the build-up of plaque, which can lead to decay and decalcification of the teeth;
  • Diet must be adapted: certain foods (hard or “sticky”) should be avoided during treatment;
  • Visits are necessary (approximately every 6 to 8 weeks) to ensure that the treatment is progressing properly.
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