ORTHODONTICS FOR CHILDREN AND ADOLESCENTS
 

Prevention is better than a cure!
 

It is preferable to address a patient with a mixed dentition (having both baby teeth and permanent teeth in both arches) before puberty, before any potential problems become established or worsen. This widens the range of therapeutic possibilities, and it falls under interceptive orthodontics.
 

EARLY INTERCEPTION TREATMENT: A FUNDAMENTAL PREVENTION MEASURE
 

This treatment is designed for children with primary or mixed dentition. Interceptive orthodontics

 aims to guide the eruption of permanent teeth and prevent impactions of permanent teeth.

The orthodontist leverages the potential for jaw growth to address malocclusion problems and bone base deformities (tooth-supporting structures) at an early age, promoting harmonious development of the entire facial structure. Most cases of malocclusion in children can be treated between the ages of 8 and 11.

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• Objectives and Benefits of Interception
   

• Pediatric orthodontics has both aesthetic and functional objectives.

• Promote proper and harmonious growth of the upper (maxilla) and lower (mandible) jaws and correct malocclusion (misalignment, forward-backward jaw displacement, asymmetry) at an early stage. It is essential that this jaw imbalance does not worsen during the child's growth period to avoid the need for extensive jaw surgery in adulthood (orthognathic surgery/surgical distraction in cases of maxillary constriction). It should be noted that jaw imbalance can lead to breathing and pronunciation problems. 

• Develop dental arches while preserving or creating sufficient space for the eruption of permanent teeth (through potential extractions of baby teeth). 

• Guide the proper placement of permanent teeth to achieve good alignment and interlocking of permanent teeth and avoid dental crowding, impactions (especially for canines), and the need for extracting permanent teeth later due to lack of space on the arch. 

• Ensure the proper development of oro-facial functions (swallowing, digestion, breathing, chewing, speech, etc.) and early rehabilitation of dysfunctions: atypical or infantile swallowing (repositioning exercises for the tongue to prevent tongue interposition during swallowing), mouth breathing (to avoid the development of respiratory problems, sleep disorders, and postural disorders), pronunciation and speech defects, temporomandibular joint dysfunctions, chewing and digestion problems. 

• Early intervention to address harmful habits (thumb or pen-sucking, etc.) to prevent the child from developing arch malformations later. Improve the child's smile aesthetics from a young age, increasing self-confidence.

• Optimize the child's oral-dental health by raising awareness and educating them from an early age about quality oral hygiene (limiting the occurrence of cavities and tartar). 

• Reduce the risk of injuries: fractures of maxillary incisors projecting too far forward (which could break more easily during a fall), palatal bite (lower teeth in close contact with the palate due to full overlap of lower teeth by upper teeth). 

• Shorten and simplify the duration of multi-bracket orthodontic treatment: the patient will already be familiar with orthodontics and hygiene measures during the interception phase, and major and complex problems will have been addressed in most cases at an early age.

• In some cases, interception treatment may be sufficient, and a second stage of multi-bracket treatment may not be necessary. If additional treatment with multi-brackets is required, it will be shorter, simplified, and less costly.

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​AT WHAT AGE IS IT RECOMMENDED TO CONSULT AN ORTHODONTIST?
 

There is no standard age to start orthodontic treatment. Contrary to a common misconception, one should not wait for the eruption of all permanent teeth before seeking consultation. 

Children may have malpositions that are of genetic (hereditary) or congenital origin (acquired at birth). These malformations should be addressed as early as possible. 

A child may have a cleft palate, cleft lip, or cleft lip-palate. Such children should receive early intervention. 

Consequently, orthodontic consultations may begin from birth in some special cases, but in general, they should start at the age of 7-8.

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The orthodontist assesses, makes an informed diagnosis, and determines the key time to initiate treatment based on various criteria, including:
 

• The hereditary or congenital origin of the malformation

• The intensity and severity of the deformation(s)

• The child's dental age (matching or not matching their chronological age)

• The child's level of cooperation and maturity

• The environmental context and the child's habits: thumb-sucking, pacifier or object-sucking, oro-facial dysfunctions (mouth breathing, nasal or mixed breathing, atypical swallowing, tongue position, volume, and mobility)
   

The treating dentist determines the appropriate time for consultation and may involve the orthodontist. 

You may even be referred to the orthodontist by other practitioners (osteopaths, ear, nose, and throat specialists, speech therapists, pediatricians) when certain dental or skeletal dysmorphisms are detected, or if there are large tonsils.

Early screening is essential because the earlier a problem is intercepted, the fewer negative repercussions it will have on the child's development. It also makes it easier to anticipate and manage cases that could later become critical and complex to treat.
 

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