Early interceptive orthodontic treatment usually starts before the eruption of the permanent teeth or when the child has very few permanent teeth present. The goal at our office is to guide the growth of the upper and/or lower jaw to make adequate space for the eruption of all the permanent teeth. We feel that children should be evaluated by the age of four to see if there is a bone problem (orthopedic) or a tooth problem (orthodontic).

Narrow Smile	Broad Smile

If the patient has a problem such as the upper jaw being too narrow, or an underdeveloped lower jaw, this will require a special appliance called a functional jaw orthopedic appliance to correct the problem. Minor tooth crowding can also be corrected early if it appears as though it may compromise the eruption of other permanent teeth.

Underdeveloped Lower Jaw	Normal Jaw 7 Months Later

It is always less expensive to correct a problem when the patient is younger rather than wait for the problem to become more serious in the future.

Other benefits of early treatment:

• Improve profiles, smiles and self-esteem
• Correct harmful habits, such as thumb sucking and tongue thrusting. Functional appliances develop the arches and make more room for the tongue.
• Improved speech
• Reduction of the time in fixed braces and frequently eliminates the need for the extraction of permanent teeth
• Increases nasal breathing which improves health
• Eliminates airway constriction
• Creates beautiful broad smiles by developing the arches
• Eliminates grinding of the teeth at night
• Prevents headaches and earaches

Cross Bite Pre-Treatment	Cross Bite Corrected 3 Years Later

FUNCTIONAL HABITS

Functional habits include thum sucking, mouth breathing or a tongue thrust habit which can contribute to the unfavorable growth of the jaws. Oral habits can commonly cause the upper front teeth to stick out and can contribute to speech problems. The best way to intercept a habit is to first make certain that the child has a proper size airway and can breath through the nose. In cases where there are serious allergies, swollen adenoids or tonsils, a referral to an Ear, Nose & Throat Specialist must be done.

Effects of Finger Habit	Habit Corrected

After airway considerations are addressed an upper fixed habit- breaking appliance could be made to stop the oral habit. Most parents prefer the fixed appliances, which cannot be removed by the child. A tiny patient friendly crib at the front of the appliance helps to remind the patient not to place their tongue, finger of thumb in this area of the mouth. Active treatment usually takes 4 to 5 months. Then if an arch development appliance was used, the crib could be removed, and the child wears the appliance as a retainer for another 6 months to prevent a relapse.