A six-year-old child is typically too young for the comprehensive, full-mouth braces most people associate with orthodontics. However, this age is the standard time for a child’s first orthodontic evaluation, often called the “Age 7 Check-up,” as recommended by the American Association of Orthodontists. By this age, the first permanent molars and incisors have usually erupted, allowing an orthodontist to assess the underlying jaw relationship and emerging dental problems. This initial assessment focuses on monitoring growth and identifying potential issues that could be simplified with early intervention, rather than immediate treatment in every case.
Understanding Phase One Orthodontics
If treatment is necessary at this age, it is referred to as Phase One, or interceptive, orthodontics. This initial treatment is limited in scope and focuses primarily on correcting structural and skeletal issues, rather than perfecting the alignment of all teeth. Phase One aims to guide the growth of the jawbones and create space for the eventual eruption of the permanent teeth. This differs from comprehensive treatment, often called Phase Two, which uses full braces or aligners to finely align all permanent teeth.
Phase One treatment is performed while the child still has a mix of baby and permanent teeth, a period known as mixed dentition. The goal is to establish a better foundation for the permanent teeth, potentially reducing the severity of issues that would otherwise require more invasive treatment later, such as tooth extractions or jaw surgery. Addressing foundational problems early often significantly reduces the overall complexity and duration of the second phase of treatment.
Identifying the Need for Early Treatment
Early intervention is reserved for specific, functional problems that benefit from treatment while the child’s jaw is still growing. One common issue is a severe posterior crossbite, where the upper back teeth bite inside the lower teeth. This can cause an improper shift of the lower jaw, leading to uneven wear and asymmetric growth. Addressing these skeletal discrepancies early is time-sensitive because the bones are still pliable.
Another frequent concern is a significant underbite, where the lower front teeth sit ahead of the upper front teeth. This skeletal issue is much more difficult to correct once growth is complete. Protruding upper front teeth, often called a severe overjet, also warrant early treatment to reduce the risk of dental trauma or fracture during falls or sports activities. Habits like prolonged thumb or finger sucking can negatively impact jaw development and tooth alignment; Phase One appliances can help correct these behaviors before lasting damage occurs. Space management is also a focus, especially if a baby tooth is lost too early, as a space maintainer can prevent adjacent teeth from drifting and blocking the permanent tooth’s eruption path.
Tools and Timeline for Initial Treatment
Phase One treatment typically uses specialized appliances designed to influence jaw growth and create space in the dental arches. A common appliance is the palatal expander, which gently widens the upper jaw to correct crossbites and create room for crowded permanent teeth. This device works effectively because the midpalatal suture in a young child’s upper jaw has not yet fused.
For other issues, a child may receive a space maintainer, a fixed or removable device used to hold the position of a lost baby tooth’s space until the permanent tooth emerges. In some cases, a limited number of braces, often called partial braces, may be placed on the few erupted permanent teeth to correct specific angles or positions. Active Phase One treatment is relatively short, often lasting between 6 and 18 months, depending on the problem’s severity. Treatment success relies heavily on the child’s cooperation, especially with removable appliances.
Transitioning to Phase Two
Following Phase One completion, the child enters a supervised “resting phase” that usually lasts one to two years. During this time, orthodontic appliances are removed, and the remaining permanent teeth are allowed to erupt naturally into the newly created spaces. A specialized retainer may be worn to maintain the foundational corrections achieved in Phase One while the jaw continues to grow.
This resting phase allows the child to complete the transition to a full permanent dentition. Phase Two, the comprehensive stage, typically begins when the child is between 11 and 14 years old, once most or all permanent teeth have erupted. This second phase involves full braces or aligners to finely align the teeth, perfect the bite relationship, and complete aesthetic refinement. Because Phase One corrected the major skeletal and space issues, Phase Two is often shorter and more predictable than if no early intervention had occurred.