Orthodontics is the specialized practice of dentistry focused on correcting misaligned teeth and improper bite patterns. The goal is to achieve optimal dental function and a balanced facial appearance. Correcting these issues depends on beginning treatment at the most opportune time in a patient’s development. Understanding the natural progression of tooth and jaw growth is necessary to determine the ideal window for intervention.
The Initial Orthodontic Assessment
The American Association of Orthodontists (AAO) suggests that a child’s first visit to an orthodontist should occur around age seven. By this age, the child typically has a mix of permanent and baby teeth, which is a transitional phase known as mixed dentition. This timing allows the specialist to evaluate the developing bite and jaw structure before any major problems become established. This initial assessment is primarily observational and diagnostic, meaning treatment is rarely started immediately.
The orthodontist uses this early screening to look for potential issues that could complicate future treatment. They check for patterns of jaw growth, crowding, or the early detection of bite issues like crossbites or overbites. Identifying these developmental concerns early provides an opportunity to monitor the situation or to intervene strategically later. This evaluation establishes a timeline for the child’s future orthodontic needs, even if the only action is regular monitoring of growth.
Interceptive Treatment (Phase I Braces)
If the initial assessment reveals a developing skeletal or dental issue that is best corrected while the jaw is still growing, interceptive treatment (Phase I) may be recommended. This early intervention typically occurs between the ages of six and ten, before all permanent teeth have erupted. The purpose of Phase I is not to achieve full alignment, but to minimize the severity of a problem or improve the environment for incoming permanent teeth. Correcting a severe skeletal discrepancy early can prevent the need for more invasive procedures like tooth extractions or jaw surgery later on.
Phase I treatment commonly uses appliances like palatal expanders to widen a narrow upper jaw and create space. Addressing a posterior crossbite with an expander is most effective while the bone sutures in the palate are still pliable. Other goals include guiding jaw growth to correct underbites or overbites, or breaking harmful oral habits like prolonged thumb-sucking. Once Phase I is complete, a resting period follows, allowing the remaining permanent teeth to erupt naturally before the next phase of treatment is considered.
Comprehensive Treatment (Phase II Braces)
Comprehensive treatment, or Phase II, is the stage most people associate with traditional braces. This phase usually begins between the ages of 11 and 14, once most or all of the permanent teeth have emerged. The adolescent years are often considered an optimal time for full-scale orthodontic work because the patient’s remaining growth can be utilized to aid in jaw alignment. The goal of Phase II is the final, precise positioning of every tooth in the dental arch.
This stage focuses on achieving an ideal, stable bite and correcting any remaining tooth alignment issues. Full braces or clear aligners are applied to all permanent teeth to fine-tune their positions and perfect the occlusion. If a patient underwent Phase I treatment, the second phase is often shorter and more straightforward because the underlying skeletal issues have already been addressed. The duration of Phase II typically lasts between 12 and 30 months, ensuring a functional bite that supports long-term oral health.
Orthodontics for Adults
Orthodontic treatment is not limited to childhood or adolescence; age itself does not prevent alignment. Many orthodontic patients are adults seeking to correct issues that were never treated or developed later in life. Treatment differs since an adult’s growth plates have closed, meaning the jawbone is fully developed and denser. Tooth movement may take longer due to the increased ossification of the alveolar bone surrounding the roots.
Adult patients often present with pre-existing conditions that require a coordinated approach with other dental professionals. Existing dental restorations or compromised periodontal health must be managed before and during tooth movement. The desire for less noticeable treatment has led to a rise in the popularity of aesthetic options for adults, including ceramic braces and clear aligners. While severe skeletal discrepancies may require orthognathic surgery, milder cases benefit from alignment to improve oral hygiene and reduce excessive tooth wear.