Yes, a person can get braces while still having baby teeth, but the type of orthodontic treatment depends on the child’s dental development stage and the intervention goals. Treatment at this early age focuses on guiding growth and correcting severe problems before they worsen, rather than achieving final alignment. This early approach is often referred to as phased treatment, occurring when both primary (baby) and permanent teeth are present. This strategy utilizes a child’s natural growth process to achieve results that would be difficult later on.
The Significance of the Mixed Dentition Stage
The period when a child has a mixture of both primary and permanent teeth is known as the mixed dentition stage, typically occurring between the ages of six and twelve. This transitional phase begins with the eruption of the first permanent molars and ends when the last baby tooth is naturally lost, around age 12 or 13. During this time, the development of the jaw and the eruption path of the remaining adult teeth are actively underway.
The deciduous teeth act as natural space maintainers for the underlying permanent teeth. They preserve the necessary width and length of the dental arch, ensuring that the permanent teeth have enough room to erupt into their correct positions. If a baby tooth is lost too early due to decay or trauma, the adjacent teeth may drift, which can block the path of the permanent tooth. Monitoring the timing of baby tooth loss is an important part of orthodontic planning during this stage.
Phase I: Interceptive Treatment While Baby Teeth are Present
When early treatment is necessary, it is defined as Phase I, or interceptive orthodontics, and is designed to address significant skeletal or dental problems while the child is still growing. This phase usually begins around age six to ten. The primary goal is not to straighten every tooth but to create a healthier environment for the permanent teeth to erupt, preventing issues that might later require extractions or jaw surgery.
Correcting Jaw Issues
A major focus is correcting crossbites, which occur when the upper teeth sit inside the lower teeth, often requiring a palatal expander to gently widen the upper jaw. Since the bones of the palate are not yet fully fused, this appliance can effectively modify jaw growth to establish a proper bite relationship. Interceptive treatment also manages severe crowding by creating necessary space, which reduces the likelihood of impacted permanent teeth.
Appliances Used
Appliances used in Phase I are specialized. They include devices like space maintainers to hold open the spot for an incoming adult tooth if a baby tooth is lost prematurely. In some cases, limited or partial braces may be applied, often involving brackets placed only on the four permanent molars and a few permanent incisors. This targeted use helps to align specific teeth or segments of the arch without involving all the baby teeth. Correcting harmful oral habits, such as prolonged thumb-sucking or tongue thrusting, is also an important goal, as these habits can significantly distort jaw development and tooth position.
When to Wait for Comprehensive Orthodontics
Not every child requires Phase I treatment, but those who do will eventually transition to Comprehensive Orthodontics, or Phase II. This second stage is the traditional, full-mouth treatment associated with braces or clear aligners. Phase II typically begins once all or nearly all of the baby teeth have naturally exfoliated, usually around ages 11 to 14.
Waiting until this later age is necessary because the goal of Phase II is to achieve the final, precise alignment of every permanent tooth and establish a stable, functional bite. Full braces or aligners require a complete set of permanent teeth to act as stable anchors for the controlled, three-dimensional movement needed for final positioning. Starting comprehensive alignment too early would require moving the same teeth multiple times as new permanent teeth emerge.
For children who completed Phase I, a “resting period” follows the initial treatment, allowing the remaining permanent teeth to erupt naturally while the jaw continues to grow. The orthodontist monitors the child’s dental development during this time to determine the optimal timing for the start of Phase II. This systematic approach ensures that the final, comprehensive treatment is as efficient and effective as possible, building upon the foundational improvements made during the earlier interceptive phase.