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On this page, we will address all aspects of Phase 1 Orthodontics, including Early Treatment, Early Warning Signs, Appliance Therapy, and Headaches in Children. Be sure to visit the Frequently Asked Questions page, as well as use the Search feature to the right.

Early Treatment
Early interceptive orthodontic treatment usually starts before the eruption of the permanent teeth or when the child has very few permanent teeth present. The goal at our office is to guide the growth of the upper and/or lower jaw to make adequate space for the eruption of all the permanent teeth. We feel that children should be evaluated by the age of four to see if there is a bone problem (orthopedic) or a tooth problem (orthodontic).


If the patient has a problem such as the upper jaw being too narrow, or an underdeveloped lower jaw, this will require a special appliance called a functional jaw orthopedic appliance to correct the problem. Minor tooth crowding can also be corrected early if it appears as though it may compromise the eruption of other permanent teeth.

It is always less expensive to correct a problem when the patient is younger rather than wait for the problem to become more serious in the future.

Other benefits of early treatment:
Improve profiles, smiles and self-esteem
Correct harmful habits, such as thumb sucking and tongue thrusting. Functional appliances develop the arches and make more room for the tongue.
Improved speech
Reduction of the time in fixed braces and frequently eliminates the need for the extraction of permanent teeth
Increases nasal breathing which improves health
Eliminates airway constriction
Creates beautiful broad smiles by developing the arches
Eliminates grinding of the teeth at night
Prevents headaches and earaches

Functional habits include thumb sucking, mouth breathing or a tongue thrust habit which can contribute to the unfavorable growth of the jaws. Oral habits can commonly cause the upper front teeth to stick out and can contribute to speech problems. The best way to intercept a habit is to first make certain that the child has a proper size airway and can breath through the nose. In cases where there are serious allergies, swollen adenoids or tonsils, a referral to an Ear, Nose & Throat Specialist must be done.

After airway considerations are addressed an upper fixed habit- breaking appliance could be made to stop the oral habit. Most parents prefer the fixed appliances, which cannot be removed by the child. A tiny patient friendly crib at the front of the appliance helps to remind the patient not to place their tongue, finger of thumb in this area of the mouth. Active treatment usually takes 4 to 5 months. Then if an arch development appliance was used, the crib could be removed, and the child wears the appliance as a retainer for another 6 months to prevent a relapse.

Early Warning Signs

deepbite.PNGDeep Bite
Do the upper teeth completely hide the lower teeth when you bite down, or does your child bite on the roof of their mouth?

openbite.PNGOpen Bite
Do the upper and lower teeth not meet in the front when your child bites together?

Do the upper front teeth seem to be more noticeable and stick out quite a bit, compared to the lower front teeth?

Facial Asymmetry
When looking at your child from the front does it appear that their face, or chin are shifted to one side. Are they growing crooked?

When you look into your child's mouth are the upper teeth on the inside of the lower teeth? If you think of the upper jaw as the garage and the lower jaw as the car - the garage should be bigger than the car!

Does your child suck their finger or their thumb? Do they breathe through their mouth instead of their nose? Do they stick their tongue between their teeth when they swallow?

Are the permanent teeth starting to come in crowded?

Does your child complain frequently of headaches? If your child grinds their teeth, or has a deep bite, the muscles may be over worked and can contribute to headaches in children.

Sometimes a bad bite or a deep bite can cause undue pressure on the small membranes of the ear, contributing to earaches.

These are all sign that your child may need early intervention!

Functional Appliances work with your child's growth and development to guide the jaws to their proper size.

Contact us for an assessment of your child, if you have noticed any of the above symptoms.

Appliance Therapy
appliancetherapy.PNGFunctional Appliances are used mainly in growing children to help solve the problem of narrow upper and lower jaws, which could cause crowding of the permanent teeth. When the narrow upper and lower jaws are developed to normal shape and size with functional appliances, in the majority of cases it is not necessary to extract permanent teeth.

Most children with crowded teeth and bad bites have narrow jaws and underdeveloped lower jaws, which could be corrected with functional appliances. Functional appliances help correct the bone problems, while the tooth problems are corrected with the orthodontic braces.

narrowarch.PNGNarrow Arch - Posterior Crossbite Right

broadarch.PNGBroad Arch - 4 Years Later

The ideal age for the use of functional appliances is between ages seven and eleven, when the cooperation level is the highest. However, functional appliances can be utilized as early as age 4, if the upper jaw is too narrow and is having a negative effect on the child's breathing and speech. Arch Development (functional appliances) can also be used in adults to develop the arch to a more normal shape and size before applying the braces.

The use of functional appliances can reduce the time the child must wear fixed braces and also can reduce the need for the extraction of permanent teeth. Functional appliances develop the dental arches so that all the permanent teeth can erupt, which ensures an outstanding profile, broad smile and healthy jaw joints.

Headaches In Children
Numerous children today suffer from headaches, which are frequently caused by a structural imbalance between the upper and lower jaws. The three main types of structural imbalances include a narrow upper arch, a deficient lower jaw and patients who have a vertical problem, evidenced by a deep overbite. A high percentage of these children who suffer from these structural imbalances will have some of the following:

Tired Jaws
Sore Teeth
Worn Teeth
Neck Ache
Clicking Jaw Joints
Ear Ache
Ringing in the Ears
Facial Deformity

Tired Jaws
If the jaws become tired after chewing gum or eating chewy foods, this is one of the earliest signs that something is wrong with the functioning of the chewing system. The human jaw is so well designed that it is impossible for the jaws to become tired unless the jaws are not properly aligned. The most common problem is a lower jaw, which is deficient or well behind the upper jaw. These patients appear to have protruding upper teeth but in the majority of these cases the lower jaw is positioned behind the upper jaw. If any tiredness of the lower jaw should occur, the child should be examined by a dentist trained in the area of TM Dysfunction (TMJ) a jaw joint problem.

Jaw joint (TMJ) problems are beginning to develop when a child experiences headaches. Pain from headaches is not normal, especially in young children. Normal children are healthy, pain-free and have relatively low stress levels. Therefore, headaches that do occur are a sign that the system is overloaded. Headaches of once or twice a month can easily be an early warning sign that should be taken seriously.

Neck Aches
Poor posture combined with a jaw problem significantly overloads neck muscles creating pain and discomfort. These problems tend to get worse as the children get older if the structural problems, as discussed previously, are not corrected. Early evaluation and treatment can go a long way to providing a lifetime of better health and comfort for our young patients.

If your children have any of the above problems, please consider making an appointment with a dentist. For an assessment appointment please call our office.

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