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.
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
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