Bravo to the Wall Street Journal for its front page article on early orthodontic treatment last month. It eloquently addressed our philosophy to treat only when necessary, and answers why we are not like other offices who may routinely propose multi-phase plans beginning at early ages.
That being said, we agree there are important indications for interceptive (Phase 1) treatment. As the article says, “Early treatment makes sense for an underbite or a narrow upper arch, problems that are easier to correct while the jaw is still growing. Treating patients as young as 7 or 8 years old with a "palatal expander" widens the upper jaw, so the upper teeth line up better with the lower teeth. This may make the second round of treatment, when the patient is a teenager, quicker and easier. Kids with crossbites also may benefit from such early treatment, although they too may still need a second round. We might also add that prematurely extracted teeth (due to crowding or decay) often require a simple appliance (space maintainer) to prevent loss of precious space.
The article continues, “For one of the most common conditions—a Class II Malocclusion, commonly known as an overbite, "overjet" or buck teeth—studies indicate there aren't measurable benefits to early treatment. Starting treatment early for this condition usually means a second phase of treatment is coming and with no guarantee it will be any easier than without early treatment. For this condition, early treatment also usually means longer overall treatment time and a higher bill at the end. Sometimes there are psychological reasons for correcting crooked or buck teeth early: A child may be getting teased, or a parent may worry the teeth will be knocked out.” This is the exception, not the rule.
The article concludes with, “Children who had early treatment did spend less time, on average, in the second phase of treatment. But taking both phases into account, their total treatment time was considerably longer. At the end, only small differences were noted in front-to-back jaw position between the groups” "There is no doubt about this conclusion," says Gregory King, professor of orthodontics at the
These findings are not new to the profession, and speak to our sensibilities as practitioners and mothers. These are the standards we would apply to our own families, and hence to yours.
We invite questions to the article and our response. Please email any questions to firstname.lastname@example.org.