The American Association of Orthodontists, recommends that your child’s first orthodontic consultation should happen no later than age 7.
My recommended age for Phase 1:
For girls, 7 and 9 ½ years of age.
For boys, 8 and 10 ½ years of age.
Why?
The primary cause for most of these issues is a narrow maxillary transverse. The upper jaw doesn’t develop enough width and can cause an array of problems.
The upper & lower jaws grow in three different dimensions; width (left to right), up and down, & front to back. Width is mostly done growing by the age of 5. The jaw continues to develop vertically (or up and down) and finally front to back (anteroposterior). All of this is happening when the child is 7-8 years of age and finishes about the time a child finishes pubertal growth. We rely on this front to back growth to make space for the adult teeth. More than 80% of children are not developing the width needed to have space for all of the adult teeth resulting in moderate to severe crowding.
What’s the goal of starting this early?
Phase 1 reduces the chances of needing first premolar extractions, either two or four most often recommended. The chance of extractions is reduced to less 2% for children who begin maxillary expansion with a BONDED expander when they are around 7-8 years old in my office. This percentage increases to around 10% or less if they begin before their 12th birthday if the patients follow my treatment recommendations.
In my treatment of children older than 15 years of age all the way to age 86, considered to be the adult patient with no more growth remaining, I have still been able to avoid extractions greater than 85% of the time. The biggest concern is a substantial decrease of long term stability.
The goal of Phase 1, or the use of an expander, is to positively influence the direction or growth of the jaw bones before they fully develop; the earlier the better. A good analogy for this is to think about a potter who has the desire to make a bowl. It is easier to start with a lump of clay and model the bowl in the desired shape and size than to take a partially formed bowl and reshape it.
Remember this: Most of the time, crowded or crooked teeth are a result of BONE problems, and braces alone are not always the best answer. It’s best if we can move the jaw bones earlier to have the best success without having to camouflage the problems and extract teeth.
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