Early Treatment


Timing is everything – Early Phase I (Interceptive) orthodontic treatment is essential in establishing and influencing proper jaw growth, create more space for crowded teeth, help to correct harmful habits, including early childhood sleep apnea and improve facial aesthetics.

The American Association of Orthodontists (AAO) recommends that your child’s first check-up with an orthodontist be performed when an orthodontic problem is first recognized, but no later than age 7.

What are the advantages of early phase I interceptive treatment?

Some of the most direct results of interceptive treatment are:

  • Creating room for crowded, erupting teeth
  • Creating facial symmetry through influencing jaw growth
  • Reducing the risk of trauma to protruding front teeth
  • Preserving space for unerupted teeth
  • Reducing the need for tooth removal
  • Reducing treatment time with Phase II braces

Following are the most common Phase I – Interceptive Orthodontic treatment recommended:

The Palatal Expander is an orthopedic appliance designed to widen your upper jaw by gently separating the bones of the palate. It works best in teenagers younger than 15 years old, because below this age, the bones of the upper jaw are still pliable. The palatal expander consists of a screw that is attached to the teeth by means of bands that go around your teeth. The expander is activated by turning the screw with a key. As the upper jaw is widened, a space may develop between the front teeth. This space will generally close by itself within a month. Once expansion is completed, the expander will remain in the mouth for approximately three months to stabilize before being removed.

It takes a few days to get used to the expander. Initially there will be some lisping but within a week your speech will be back to normal. Until you get used to eating with your expansion appliance, eat plenty of soft foods. Pain is rarely experienced, but you may feel the initial pressure on your teeth, in the middle of your palate, and your cheeks. Sometimes patients may experience a slight headache. You can take over the counter pain medication to alleviate the discomfort. As with any orthodontic appliance, remember to stay away from hard sticky foods that can break and pull apart your appliance. Be sure to brush all parts of your expansion appliance as well as your teeth.

The most common treatment headgear is used for is correcting anteroposterior discrepancies. The headgear attaches to the braces via metal hooks or a facebow. Straps or a head cap anchor the headgear to the back of the head or neck, in some situations both are used. Elastic bands are used to apply pressure to the bow or hooks. Its purpose is to slow or stop the upper jaw from growing, hence preventing or correcting an overjet.

The lower lingual holding arch is a holding appliance. It prevents the permanent molars from shifting forward allowing crowded teeth to spread out. It remains in place until permanent teeth begin erupting.

Two bands are cemented to two lower molars. Attached to the bands is a U-shaped bar. The patient may experience slight discomfort when first placed. Whatever household pain reliever you prefer, may be used to remedy these situations.

The Nance Holding Arch (“Nance button”) consists of two bands around the back teeth and an acrylic button that covers part of your anterior palate. The Nance button can be used as a space maintainer, in cases in which the baby teeth have been lost prematurely, and the first molars need to be prevented from coming forward. The Nance holding arch is also used for additional support to help drive back the anterior teeth, after the back teeth have been actively driven back with the Spring Jet appliance.

This appliance causes little discomfort and has little effect on the speech. Please stay away from hard sticky food that can break and pull apart your appliance. As with any orthodontic appliances, you should brush all parts of your appliance as well as your teeth.

This appliance incorporates the use of upper and lower bite blocks to position the jaw more forward to correct certain conditions. The appliance was first developed by Scottish Orthodontist William Clark and Orthodontic Technician James Watt in 1977. Becoming more and more widespread in the United States, the twinblock is quickly becoming the most popular functional appliance in use.

The Bite Plate is designed to correct a deep bite (when the upper front teeth come down too far over the lower front teeth). Initially, there may be an adjustment period and speech may be affected for a short period of time. When wearing your bite pate, it is normal if your back teeth do not meet all the way. It may take a few weeks to completely adjust to your new bite plate.

For optimal results, the bite plate should be worn 24 hours a day and only removed for eating and brushing. As with any orthodontic appliance, you should brush all parts of your bite plate as well as your teeth. Depending on the amount of correction needed, the bite plate may be worn for 3 to 6 months. Make sure to bring it to every appointment.

Closeup of Someone Smiling With Elastics on Their Braces

During various times of treatment, small elastics ( rubberbands) are used as a gentle but continuous force to help individual tooth movement and/ or the aligning of jaws. In order for this force to remain constant, elastics must be worn all the time, especially when eating because that is when the jaw is most active.

Elastics should only be removed when brushing and should be changed daily, or if they break. The more often you wear your rubberbands, the shorter your treatment time may be. Therefore you will obtain the best results by wearing your elastics 24/7.

Closeup of a Hawley Retainer

Hawley retainers are used following the removal of braces. They aid in allowing the teeth to settle into their new position in the jaw. They consist of wire and acrylic and come in a multitude of colors and designs. They are custom made for each patient following the removal of the braces.

Closeup of a Clear Retainer

Essix retainers are clear retainers that are worn following the removal of the braces. They are popular because they are nearly invisible and are very durable. They are custom made for each patient following the removal of the braces.

Illustration Showing a Bonded Retainer

A bonded retainer consists of a braided wire that is glued to the backside of the lower anterior teeth. It is used in place of a removable retainer and is placed following the removal of one’s braces. They are popular because one does not have to remember to put a retainer in the mouth.

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