Early intervention orthodontics in preschool children

By Dr Sven Jensen

Background

One of the most common questions asked at an orthodontist is “when can I get my braces on?”. It may be confusing that two qualified orthodontists suggest starting treatment at different times and even disagree about the treatment that should be offered. Whilst most braces go on between 12–14 years of age, most orthodontics agree that certain problems should be treated early to promote normal growth and development of the teeth and face. A research group from Italy recently published an article on the problems that benefit from early intervention.

Orthodontic screening and treatment timing in preschoolers. Grippaudo C, Paolantonio EG, Luzzi V, Manai A, La Torre G and Polimeni A. 2019 Clinical and Experimental Dental Research

Research question

What is the prevalence of orthodontic problems (malocclusion) and predisposing factors in an Italian pre-schooler population? What did they do? They carried out orthodontic examinations on 1405 children between 2 and 7 years of age, looked at the teeth, took measurements and asked questions about their medical history. Using the results from the examination, they classified the patients into low, medium and high risk of future orthodontic or facial growth problems and recommended treatment and observational protocols depending on the category. The protocols included treatment for those in the high-risk category and observation at 6 or 12-month intervals for the medium and low-risk categories.

Results of the study

Over 50% of the children were classified as high risk whereas one-third of cases were low risk and the remaining children had moderate risk. The most common problems included bad habits (such as thumb or finger sucking) followed by mouth breathing and increased over-jet (where the upper front teeth protrude forward). In addition to orthodontic issues, nearly one-quarter of children had decay on their baby teeth which also classified them as high risk.

Summary

In all areas of medicine, prevention is the first strategy to reduce the prevalence of diseases and the biological costs and expenses related to health treatments. The high frequency of orthodontic and dental issues in this young age group highlights the importance of early orthodontic examination. Early diagnosis and treatment of common problems, like thumb and finger sucking or mouth breathing, are relatively easy to correct and will steer children back onto the regular path of development reducing the need for complex treatment later on. Unley Orthodontics follows the guidelines of the Australian Society of Orthodontists which recommends that all children should have an orthodontic examination by the age of 7. The question of “when can I get my braces on?” is, therefore, not an easy one. For many of our patients, six months of braces before the age of 10 may even preclude the need for braces in adolescence. A stitch in time saves nine!