Phase I or early orthodontic treatment is not the time to create one’s “forever smile.” Phase I treatment is useful:
- To resolve problems that will interfere with normal growth and development of the jaws (Read blog post here)
- To resolve problems that will prohibit permanent teeth from erupting normally (Read blog post here)
- Try to avoid extraction of permanent teeth during full orthodontic treatment
In this blog post, I’d like to cover #3: the main reasons why early, or Phase I, treatment may be indicated to alleviate problems that may result in severely crowded teeth.
Why is it important to correct severely crowded teeth? Crowded teeth can make oral hygiene very difficult. Severely crowded teeth are difficult to brush and floss. Finally, crowded teeth can increase the likelihood of cavities and gum disease.
One method to resolve severe dental crowding is an extraction of permanent teeth. While extraction of permanent teeth is a perfectly acceptable orthodontic solution, most people would rather not have permanent teeth extracted, if it can be avoided. Often, Phase I treatment can help resolve problems that may lead to excessive crowding. These include:
- Extremely narrow jaws. In particular, the upper jaw can be widened if it is too narrow. The ability to widen the upper jaw, however, is lost at about age 15, when the two halves of the upper jaw fuse permanently.
- Early loss of baby teeth. There are many reasons why baby teeth can be lost early. As examples, they can be lost naturally, they can be removed due to cavities, or they can be lost due to trauma. Even if baby teeth are not pulled due to cavities, the presence of large cavities in baby teeth can result in space loss.
- Ectopic eruption of teeth. This is when adult teeth erupt in a place where they shouldn’t erupt. Often, it causes early loss of baby teeth and space loss.
- Large teeth, small jaws. The size of teeth and the sizes of the upper and lower jaws is genetic. It frequently happens where a child will inherit large teeth from mom and the small jaws of their father. This can lead to some very crowded teeth!
Severe crowding can often be identified as soon as the four permanent incisors have erupted in the mouth; typically around age 8. Phase I treatment can help manage this crowding so that it does not becomes worse and necessitate extraction of permanent teeth. Likewise, there is a unique ability to manage space when some baby teeth are still present, as opposed to waiting until all the permanent teeth have erupted.