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Treatment for Children

The American Association of Orthodontists and the American Dental Association recommends that children be evaluated for orthodontics by age 7. That might be surprising to hear for parents who had braces as teens. There are benefits to being seen before all of the permanent teeth come in. Instead of extracting healthy teeth to make room in a crowded mouth, appliances have been developed to change the size and shape of the palate to make the necessary room for teeth that have yet to erupt. Another proven benefit of palate expansion is that since the floor of the nose and the roof of the mouth are attached, the floor of the nose is also increased therefore increasing the volume of the nasal airway allowing patients to breathe better, snore less and get a more restful sleep. This is called Early Intervention or Phase Treatment. Patients are often seen for Phase 1 of treatment for orthopedic changes with a few braces on permanent teeth and then Phase 2 treatment or what most would consider “traditional” braces occurs when all of the permanent teeth erupt and braces are placed on every tooth to straighten teeth and fix any bite issues.

How does growth relate to orthodontics?

We take hand-wrist x-rays for girls beginning at age 9 and boys at age 11 to determine the patients Skeletal Maturation Index (SMI). The SMI indicator ranges from 1-11; one being at the beginning of one’s growth and 11 when a person is done growing. The palate, or roof of your mouth, is a bone that develops in two pieces with a soft spot or suture located in the middle of the roof of your mouth where the two pieces of bone join. It remains that way until a person reaches SMI 11, at which time the bone fuses. During growth when the palate is soft, orthodontic appliances can be used to widen the palate to make room for permanent teeth. There are also certain appliances used in comprehensive treatment and Phase II treatment that work best when timed with growth. Placing teeth in their permanent position while a child is growing makes the tooth position more stable long term. This x-ray is one tool that our practice uses to determine the optimal time for planning a patient’s orthodontic treatment.

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