Kids Braces – Phase One


Decades ago most orthodontists would start orthodontic treatment in children that had
reached their early teenage years. By this age the permanent teeth had already erupted and
the orthodontist could easily assess what orthodontic treatment was needed. Today most
orthodontists would recommend having a child screened at age seven—before the permanent
teeth have erupted. Why start orthodontic treatment this early? The jaws can be changed more
easily to permit all or most of the erupting teeth in a process called interceptive orthodontics.
Interceptive orthodontics and orthopedics
In most cases, interceptive orthodontics is more accurately considered orthopedics since it is
the jaw that is altered rather than the teeth. As the child’s jaw is developing several functional
orthodontic appliances are used to change the shape and size of the jaw. In most cases the jaw
is expanded and lengthened to accommodate all of the teeth. This prevents crowding and
promotes the eruption and extrusion of the teeth. Because the jaw is moved rather than the
teeth at this stage, the process would be more accurately called dentofacial orthopedics but is
commonly referred to as interceptive orthodontics.
Dental devices used in interceptive orthodontics
There are a number of dental devices that are used to change the shape of the jaw and palate
in young children. These devices can be removable, like retainers. They can also be fixed, like
the Nance appliance which holds the molars in place until other permanent teeth have erupted.
The dental devices can work primarily on the teeth, on the jaw, or both. For example, a rapid
palatal expander (also known as a Hyrax appliance) is a device that may be anchored to the
upper teeth, but it actually provides pressure to the palate to increase its size.
Alternatively, if a child loses a tooth, the orthodontist may require a space maintainer
The goals of interceptive orthodontics
The goals of interceptive orthodontics can be described as preventative rather than corrective
in that this orthodontic treatment is aimed at preventing problems from developing before
they need to be treated later. This is not to say that interceptive orthodontics can eliminate the
need for braces. On the contrary, interceptive orthodontics is usually just the pretreatment or
first treatment phase in children before active treatment with braces begins.