Topic Overview

Many treatment options are available for
malocclusion (“poor bite”), and expert opinions differ
about timing. Your dentist or orthodontist may give you a choice between early
or later treatment or may prefer one particular approach.

these points:

  • An underdeveloped lower jaw (mandible) is best
    treated as soon as a child is old enough to cooperate with treatment (age 5 or
  • The amount of space for teeth does not increase with time.
    In fact, it gradually shortens throughout adulthood, because the teeth
    naturally drift toward the front.

    • In cases of severe crowding of baby (primary) teeth, the need for future orthodontic
      treatment is clear. Some practitioners choose early treatment using
      growth modification. Others use
      serial extraction or wait to use extraction and a
      single stage of orthodontic treatment.
    • In mild cases of crowding
      (when some
      permanent teeth have already come in, or erupted),
      malocclusion may improve because of your child’s jaw growth through the teen
      years. You may avoid orthodontic treatment altogether by waiting until more
      permanent teeth have come in.
  • Ideal timing of two-stage treatment can vary
    depending on the what the condition is, when the adult teeth come in, and how much growth
    is needed to correct the malocclusion. Many children who begin treatment by the
    second or third grade are finished with orthodontic treatment before they begin
    high school.
  • Two-stage treatment often costs more than one-stage
  • Children tend to be more cooperative than teenagers when
    it comes to wearing their appliances for a certain number of hours a day.
    Children typically allow closer parental supervision than teens do. Completing
    two-stage treatment before the teen years may be
  • Two-stage treatment spans a longer period of time, with a
    break between the first and second stages. Parents and the dental professional
    must make treatment as easy as possible for the child to avoid “burnout” before
    the child has completed treatment.

If you have any doubts about whether a particular dental
professional’s approach is right for you, seek a
second opinion from another dentist or

Related Information


ByHealthwise Staff
Primary Medical Reviewer Adam Husney, MD – Family Medicine
Specialist Medical Reviewer William F. Hohlt, DDS – Orthodontics

Current as ofMay 7, 2017