Early Braces Treatment for Malocclusion

Early braces treatment for malocclusion is a type of dentistry intended to diagnose and treat developing orthodontic problems in young children. This treatment can be carried out between the age of 6 and 10 years old, which is where the jaw is still developing and primary (milk) teeth are changing to permanent teeth. While traditional braces are used in teenagers or adults to treat existing malocclusions (overcrowding, overbite, underbite, crossbite), interceptive orthodontics are used to help prevent or minimize future malocclusions. Additionally, dentistry has defined interceptive orthodontics as a proactive treatment which aids in making future treatment less invasive and in some cases avoids or minimizes the need for extractions or surgery.

Paediatric interceptive orthodontic treatment aims to direct the growth and development of a child’s teeth and jaw.

• Create adequate space for eruption of permanent teeth.
• Reduce harmful oral habits (thumb sucking, tongue thrusting).
• Improve bite relationships at an early stage.
• Improve facial symmetry and aesthetics.
• Prevent future comprehensive orthodontic problems.

The earlier the intervention, the less orthodontic treatment is required in adolescence or, in some cases, prevents the need altogether.

Individuals aged between 6 to 10 years old and display symptoms of malocclusion or irregularities in the jaw.

Common conditions that may lead to early orthodontic treatment include:

• Crowded or overlapping teeth.
• Loss of baby teeth too early or too late.
• Crossbite, open bite or deep bite.
• Front teeth that stick out too much.
• Mouth breathers.
• Thumb-sucking or pacifier dependency beyond 4 years of age.

Most dentists will recommend an orthodontic screening for all children by age 7, as it allows for early detection and potential interceptive strategies.

Interceptive orthodontics includes many different types of appliances and techniques for specific purposes. Some examples are:

• Space Maintainers - If a baby tooth is lost prematurely, space maintainers will hold space for permanent teeth.
• Palatal Expanders - Palatal expanders can help widen the upper jaw to correct crossbites, as well as create space for permanent teeth.
• Partial Braces - Partial braces are placed on specific teeth in order to help align them.
• Habit Breaking Appliances - These appliances can help break habits like thumb sucking or tongue thrusting.
• Functional Appliances - Functional appliances can help guide jaw growth if there are skeletal issues (e.g. twin block appliances).

Each appliance is designed with a specific purpose in mind and often serves to set the stage for comprehensive orthodontic treatment.

The treatment process is usually completed in different stages:

• First Consultation and Evaluation: Dentists will collect dental and medical history, X-rays, photographs, and dental impressions.
• Diagnosis and Planning: Identify malocclusion / skeletal issue. Develop a treatment plan
• Placing the Appliance: The expander, partial braces,  or habit-breaking device will be placed. Regular appointments are required to adjust the appliance or replace parts of the appliance.
• Monitoring Growth: The orthodontist will monitor the eruption of permanent teeth and the growth of the jaw before transitioning to comprehensive braces in adolescence if warranted.

Most patients move onto a period of rest before braces are applied.

Early braces treatment provides a number of benefits.

• Prevents dental problems from getting worse.
• Decreases treatment duration and complexity during teenage years.
• Enhances facial growth and balance.
• Prevents the risk of trauma to teeth that stick out.
• Provides better speech and chewing ability.
• Increases self-esteem for kids with aesthetic concerns.

• As opposed to waiting until a child is a teenager, interceptive orthodontics take advantage of natural growth for the best results.
• Can possibly eliminate or reduce the need for extraction or surgery.
• Will improve breathing and sleep in cases with jaw related airway issues.
• Has more predictable results because we guide the growth of conservative skeletal structures.
• Low risk, high reward therapy when initiated at the right (young) age.

Varies greatly depending on the child’s dental problem:

• Habit Appliances: 3–6 months.
• Palatal Expanders: 6–9 months.
• Partial Braces: 9–18 months.
• Follow-up may also be required about every 4 to 6 weeks.

Full orthodontic treatment can occur into teenage years if necessary.

In India, the cost of early braces can range between ₹10,000 to ₹60,000, depending on:

• Type of appliance used.
• City and clinic framework.
• Dentist experience and specialisation.
• Length and complexity of case.

Interceptive orthodontics is a relatively safe treatment; however, risks involve:

• Initial discomfort or soreness.
• Minor speech impediment.
• Mouth irritations; possible ulcers.
• Damaged appliance from incorrect care.
• Results affected from non-compliance by children.

Close monitoring and regular dental check-ups can help mitigate some potential risks of interventional orthodontic treatment.

There are potential disadvantages include:

• Requires commitment from the parent and child.
• Multiple visits may be inconvenient for the child.
• May not eliminate the necessity of full braces in the future.
• This treatment will not qualify for all children with orthodontic issues.

However, the benefits of early intervention can lead to substantial long-term dental health.

Other options to early braces treatment are:

• Delayed orthodontic treatment during adolescence.
• Clear aligners – Older children may use it if all permanent teeth are in.
• Orthognathic surgery, severe jaw discrepancies (older teens, adults).

Although not other options may offer the same preventative advantages as interceptive orthodontics in the initial years of growth.

Proper aftercare will ensure any permanent results:

• Excellent oral hygiene around appliances.
• Avoid any hard and or sticky food that may unseat any devices.
• Use prescribed rinses or fluoride toothpaste.
• Follow the dentist's instructions.
• Attend all follow-up visits for adjustment.
• Encourage compliance with positive reinforcements.

Parents play a vital role in supporting their child during the entire treatment phase.