While orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and development, which occurs largely during childhood. Children are often the best candidates for dentofacial orthopaedics. Therefore, it is important to screen children around 9 years of age to determine if early (Phase I) treatment is needed to take advantage of their jaw growth. 9-11 years of age is a period of significant growth in most children and it is important to take advantage of that growth in children who have certain types of bite problems:
- Lower jaw and teeth too far behind the upper teeth when biting together (overbite).
- Upper back teeth too narrow compared to the lower teeth when biting together (crossbite).
- Upper front teeth behind lower front teeth when biting together (underbite).
The Orthodontist can monitor your child’s jaw growth to determine if treatment is indicated and the most effective time for that dentofacial treatment. If treatment is indicated while there is a mixture of primary (baby) teeth and permanent teeth, it is known as Phase I treatment.The goal of Phase I treatment is to make sure the upper and lower jaws are properly aligned.
Dentofacial orthopedics is the process of “normalizing” the growth and position of a child’s jaws and minimizing any imbalances of the face and jaws.
Various appliances are used for this treatment:
- Myofunctional appliances like Activator, Bionator , Frankel’s appliance or Twin block appliances which harness forces from child’s jaw musculature to redirect jaw growth.
- Phase 1 fixed braces called 2 x 4 appliance to normalize alignment of erupted permanent teeth.
- Palatal expanders for crossbite correction.
This process often involves a two-phase treatment and often begins when the patient is around 7 or 8 years old.
Children are often the best candidates for receiving dentofacial orthopedic therapy. Beginning at a young age, your orthodontist will examine and monitor your child’s growth to determine the most effective timing to start treatment. If your child begins orthodontic treatment before all adult teeth have erupted, it is known as phase-one treatment. During phase-one treatment, your orthodontist will use treatments designed to correct your child’s jaw growth and make sure that the jaw bone is properly aligned before beginning the second phase of treatment, which usually involves braces to straighten the teeth.