Early Treatment

Niagara Peninsula Orthodontics provides patients of all ages, including children, with comprehensive orthodontic treatment in Niagara Falls, St. Catharine’s, Fonthill, and Beamsville, Ontario. A few questions that we often hear from our patients include:

• What is the difference between early orthodontic treatment and regular orthodontic treatment, and why might my child need early treatment? 
• How will early treatment benefit my child in the long run?

 Orthodontic Problems.

The Canadian Association of Orthodontists recommends that children see an orthodontist as early as age seven. At this point Dr. Pershad will evaluate whether your child will needs orthodontic treatment. Early treatment (also known as Phase-One) typically begins around age eight or nine, while Phase-Two begins around age 11 or older. The goal of early treatment is to correct the growth of the jaw and prevent any major bite problems from forming. It also helps to make room for permanent teeth to come in properly, lessening the chance of extractions in the future.

How To Tell If Your Child May Need Early Orthodontic Treatment:

• Early or late loss of baby teeth (your child should typically start losing teeth around age five, and will have all the permanent teeth around age 13)
• Difficulty chewing and/or biting
• Mouth breathing
• Your child continues to suck a thumb after age five
• Speech impediments
• Protruding teeth (the top teeth and the bottom teeth extend away from each other)
• Teeth that don’t come together in a normal manner or even at all
• Shifting of the jaw when your child opens or closes their mouth (crossbites)
• Crowded front teeth around age seven or eight 

Treatment for common orthodontic problems typically begins around age 9-14, when all of the baby teeth are gone and many of the permanent ones are in place. But there are some conditions that are much easier to treat if they're caught at an early age, when a child's natural growth processes are going full speed ahead.

Crossbite.One is severe crossbite, a condition where the upper teeth close inside the lower teeth. To treat this problem, a device called a palatal expander can be used, which gradually and painlessly widens the upper jaw; it's especially effective when the jaw itself hasn't fully developed. If we wait too long, a more complicated treatment — or even oral surgery — might be required to correct the problem.


Crowding.Another condition that may benefit from early treatment is severe crowding. This occurs when the jaws are too small to accommodate all of the permanent teeth. Either palatal expansion or tooth extraction may be recommended at this point, to help the adult teeth erupt (emerge from below the gums) properly. Even if braces are required later, the treatment time will likely be shorter and less complicated.


Protruding teeth.Early intervention may also be helpful in resolving several other problems. Protruding teeth, especially in front, can be prone to chipping and fractures; they may also lead to problems with a child's self-image. A severe underbite, caused by the lower jaw growing much larger than the upper jaw, can result in serious bite problems. Orthodontic appliances, including braces and headgear, can be successfully used to correct these problems at this stage, when the child's development is in full swing, thereby increasing the chances that surgery can be avoided.

What Causes Orthodontic Problems, & How Will Early Prevention Benefit My Child?

Orthodontic problems such as crowding of the teeth, too much space between the teeth, jaw growth problems, protruding teeth, and bad bites can be inherited or caused by injury to the mouth, early or late loss of baby teeth, or thumb-sucking habits.

Most children lose all their baby teeth by age 13. By the end of their teen years, the jawbones will harden and stop growing. Orthodontic procedures for adults often take more time and can involve tooth extraction or oral surgery. Receiving early orthodontic treatment as a child can help prevent the need for orthodontics as an adult, leaving little to no chance of extraction or surgery in the future.

Why should children have an orthodontic screening no later than age 7?

By age 7 all the permanent incisors (front teeth) as well as the permanent first molars should have erupted. If inadequate space exists, some of these teeth could become impacted. An evaluation at this time helps identify problems with eruptions.

Also at this time, we can evaluate growth discrepancies of the jaws, cross-bites (when upper teeth hit inside the lower teeth), crowding, and the development of injury-prone dental protrusions. An early orthodontic screening enables us to advise you if treatment will even be necessary, and if so, determine the best time for your child to be treated. There is no charge for an initial examination or for supervision reassessment examinations.

Some signs or habits that may indicate the need for an early orthodontic examination include early or late loss of baby teeth, difficulty in chewing or biting, mouth breathing, thumb or finger sucking, crowding, displaced or blocked-out teeth, biting the cheek or roof of the mouth, teeth that meet abnormally or not at all, jaws or teeth that are out of proportion to one another, and a smile that is not symmetrical.

Correcting Bad Habits

 Dangers of Thumb Sucking.

At one time or another, anyone may pick up a bad habit. But there are some situations where a youngster's parafunctional (detrimental to health) habits can actually influence the development and function of his or her teeth, jaws and mouth. Some examples of these are persistent thumb sucking, tongue thrusting and mouth breathing.

The sucking reflex is natural in early childhood; it usually disappears between ages 2 and 4. But if it persists much later, the pressure of the digit on the front teeth and the upper jaw can actually cause the teeth to move apart and the jaws to change shape. This can lead to the orthodontic problem called “open bite,” and may impair speech. An open bite can also be caused by the force of the tongue pushing forward against the teeth (tongue thrusting).

Mouth breathing — an abnormal breathing pattern in which the mouth always remains open, passing air directly to the lungs — is related to alterations in the muscular function of the tongue and face. It may cause the upper and lower jaw to grow abnormally, which can lead to serious orthodontic problems. Although mouth breathing may start from a physical difficulty, it can become a habitual action that's hard to break.

Various orthodontic treatments are available to help correct these parafunctional habits — and the sooner they're taken care of, the less damage they may cause. But these potential problems aren't always easy to recognize. That's one more reason why you should bring your child in for an early orthodontic screening.

What Are The Benefits Of An Early Evaluation & Treatment?

For young patients who have clear indications for early orthodontic intervention, this type of treatment presents an opportunity to:

Guide the growth of the jaws
Regulate the width of the upper and lower dental arches
Guide erupting permanent teeth to desirable positions
Lower the risk of traumatic injury to protruded upper incisors (front teeth)
Help eliminate harmful oral habits such as thumb or finger sucking which can cause open-bites
Reduce or eliminate abnormal swallowing or some speech problems
Improve personal appearance and self-esteem
Potentially simplify and/or shorten treatment time for later comprehensive orthodontics
Reduce likelihood of impacted permanent teeth (teeth that should have come in, but have not), and preserve or gain space for permanent teeth that are appearing


Niagara Peninsula Orthodontics Is Here To Help

If your child is between the ages of seven and eight and shows signs of needing orthodontic care, or you have been directed by your family dentist to visit the orthodontist, please contact our practice and schedule an appointment. Dr. Pershad and our wonderful team will provide your child with an initial exam, and discuss with you the best steps to take.



Related Articles

Early Orthodontic Evaluation - Dear Doctor Magazine

Early Orthodontic Evaluation Early detection of orthodontic problems in young children may make it easier to correct those problems in the long run. Waiting until all of the permanent (adult) teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult or even impossible. An early childhood orthodontic evaluation can yield excellent results... Read Article

Thumb Sucking - Dear Doctor Magazine

How Thumb Sucking Affects The Bite Thumb sucking can actually block the front teeth from erupting fully and can also push the teeth forward — sometimes more on the side where the thumb rested. How far out of position the teeth end up will depend on the number of hours per day the thumb was in the child's mouth and how much pressure was applied. When the pressure exerted by the thumb in the mouth is particularly strong and occurs over a long period of time, the forces can potentially influence growth of the jaws... Read Article

Orthodontics - Dear Doctor Magazine

The Magic of Orthodontics Proper alignment of the teeth is basic to “Smile Design.” Their position dictates how they work together and affects the way you look and smile. Only orthodontic treatment can move teeth into the right position. Simply put, when things look right, they probably are right. Learn the basics of smile analysis and design and whether the magic of orthodontics will work for you... Read Article