Frequently Asked Questions About Orthodontics

Early treatment has been recommended to me for my daughter.

When I had braces I had to wait for all my permanent teeth to come in.

Does early orthodontic treatment work?

Early orthodontic intervention during the mixed dentition phase is invaluable when used to intercept future problems, take advantage of available growth, reduce the need to compromise in the treatment of the permanent dentition, and make fixed appliance treatment (“braces”) easier and shorter in duration. Appropriate interceptive techniques to modify skeletal growth, gain or save space, reduce overbites, and correct cross bites should result in fewer compromises, a better occlusion during a shorter, second phase of treatment.

Will early treatment eliminate the need for permanent tooth removal?

With the advent of direct bonded brackets in the 1970s and better understanding of early treatment options by the profession, extractions for orthodontic treatment have been greatly reduced. However, there will be some circumstances where extractions of permanent teeth are an unavoidable option. It is important to evaluate the efficacy of first phase treatment fully in every case to determine if the early treatment options proposed will have a good chance of accomplishing the goal of maintaining all the permanent teeth. Sometimes, even with the best compliance, space for all the teeth cannot possibly be attained, and therefore, will not be recommended.

Will early treatment eliminate full “braces” later?

Early, first-phase treatment will address crowding, habits, cross-bites and skeletal problems while normalizing the dental arches, but will not ensure that the unerupted permanent teeth will come in correctly. One should not figure that early treatment will avoid a second phase of “braces,” but that second phase should be shorter in duration and easier to treat.

Early treatment sounds like it is the treatment of choice, but won’t multiple phases add to the total expense of treatment?

Dr. Skarin looks at a sequence of treatment that starts at Point A and finishes at Point Z. Treating from A to F with a first phase, G to K with an additional phase if needed, and finishing with an L to Z phase of “braces” should not cost appreciably more than if one waited and treated from A to Z with one phase of “braces.” However, there will be more compromises in single-phase treatment. Dr. Skarin feels that a family should not be financially penalized for choosing the less compromising multi-phase plan.

What are the potential negatives to early treatment?

There are two negatives that might be a concern, depending on the patient, and the parents will be in the best position to decide if the suggested treatment is correct for their child. The first factor to consider is that many of the appropriate interceptive appliances have a removable component to them. Thus, the appliance can be lost, or it could collect dust from lack of use.

The second factor to consider is that the overall time a child will spend using some form of orthodontic appliance and seeing the orthodontist will be longer, sometimes by years, than treating with one phase of treatment. However, as mentioned in the previous answer, the multi-phase approach should always be less of a compromise, and a better result.

There seem to be many new systems, techniques, and “braces,” both metal and invisible, that are being touted. What do you use?

Dr. Skarin will use whichever appliance will give the best result, sometimes utilizing different appliance systems on opposing arches. Being trained in multiple techniques by five different teams of faculty makes it easy to use the best of each technique or appliance in very selective ways.

In addition, since Dr. Skarin employs no assistants or associates that need to follow pre-determined treatment steps that follow a certain “system,” treatment can be modified quickly and easily to accommodate changes that occur from appointment to appointment.

It is not unusual to find self-ligating appliances on one arch and a retainer or inviable slip-cover style appliance on the other arch that might precede ceramic or crystalline brackets on the same arch to finish the treatment. Flexibility and the willingness to accommodate individual situations that are not the norm are hallmarks of Dr. Skarin’s practice.

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