Orthodontic Phases

Face First Therapy (Ages 6 – 9)

Our practice joins the American Dental Association and the American Association of Orthodontists in suggesting that the first orthodontic visit be after the first permanent teeth begin to appear. Actual treatment is rarely needed at this age however! We believe that early treatment should be directed at medical needs, stopping habits and correcting jaw issues. In other words, helping to shape the face for the future.

Examples of Face First Therapy

Our practice first works to make sure that the bones and muscles of the face are forming correctly. This involves working to ensure proper face muscle balance. In order to achieve this we encourage nose breathing, chewing with the mouth closed and swallowing with the tongue on the roof of the mouth. We even offer classes for a very reasonable cost that helps patients to do this with the help of a patented oral mouthguard device. We also may intercept by helping to get teeth to erupt into the mouth with limited appliances or retainers or removing a baby tooth or teeth. Braces are used when the situation is a bit more severe and we believe that early care will help the jaws to grow better or prevent a serious problem from getting worse.

Why are children being evaluated at such an early age?

Early evaluation and occasional treatment can guide erupting teeth into a more favorable position, preserve space for permanent teeth, and reduce the likelihood of fracturing protruded front teeth. In our practice, we pay particular attention to oral habits such as mouth breathing and thumb and finger habits as well as tongue position. This is base of Dr. Grob’s over 25 years of clinical experience.

Does early treatment benefit all children?

Early treatment, unlike early evaluation, does not necessarily benefit all children. Certain types of orthodontic problems can be more easily and efficiently corrected in the teen years when all the permanent teeth have erupted or the jaws have completed their growth. If Dr. Grob decides the patient is not ready for treatment, they are placed on our orthodontic recall program.

What is the Orthodontic Recall Program?

The orthodontic recall program is for patients who are not ready for treatment. This program enables us to monitor the growing pattern of the permanent teeth. Sometimes, poor erupted positions of permanent teeth may be eliminated with early removal of baby teeth and reduce the treatment time required for braces. We will notify your general dentist of any recommendations made during your visit. We normally see the patients on recall every 6-8 months to observe their progress as they grow. There is no fee for this program within insurance regulations and it helps the orthodontist determine the optimum time to begin treatment and achieve the best possible result for your child.

If a child has treatment early, will this prevent the need for braces as an adolescent?

Early treatment can begin the correction of significant problems, prevent more severe problems from developing, and simplify future treatment. Because all of the permanent teeth have not yet erupted when early treatment is performed, their final alignment may not have been corrected. Typically, a shortened comprehensive phase of treatment (Phase II – full braces) in the teen years, after all the permanent teeth have erupted, completes the correction. However, in rare circumstances, further orthodontic treatment may not be indicated. In our practice, all treatment fees charged for early treatment are applied to the Total Treatment Fee. This is part of our Great Smile For Life Program.

When to Start Treatment

One of the most common questions asked of Orthodontists by parents, patients and even dentists is “When should a patient first visit the orthodontist?” The American Dental Association and the American Association of Orthodontists join in the suggestion that patients first visit the orthodontist at age 7. We agree but many are hesitant to visit for fear of starting “too early”. Dr. Grob shares this concern and has devoted several years researching, publishing and practicing the Treatment by Twelve’s philosophy. For simplicity, the philosophy places patients into 3 groups based on the tooth eruption chart shown below. SO JUST COUNT THE TEETH!

This philosophy is based on the research of noted orthodontic educators Gianelly, Proffit and others.

The FIRST TWELVE PERMANENT TEETH erupt between the ages of 6 and 9

The NEXT TWELVE PERMANENT TEETH usually appear between ages 10 and 14

The FOUR TWELVE YEAR MOLARS are fully in place by about age 15 and beyond