Early treatment occurs when the child still has a mixture of primary and permanent teeth.
The age that early treatment usually commences is between the ages of seven to ten. However, ages can vary due to some patients who may experience early erupting teeth and others with late erupting permanent teeth.
The advantage of early treatment is that early diagnosis and treatment by orthodontists may help tooth eruption, guide facial growth, and often prevent more serious problems from occurring. By lessening these problems in early development stages, later orthodontic treatment may be reduced or made easier, and therefore more economical.
These passive or functional appliances include:
Lingual Arch
Lingual Arch is used to hold space and maintain the arch length in either the upper or lower jaw. It is used when there is early loss of baby teeth, or late eruption of adult teeth. The prevention of crowding can decrease the need for the extraction of permanent teeth in the future.
Space Maintainer
A space maintainer is used to hold space. It is used often when there is early loss of baby teeth and it is necessary to hold space for un-erupted teeth to ensure that other teeth don’t drift into their place and cause crowding. The prevention of crowding can decrease the need for the extraction of permanent teeth in the future.
Trans Palatal Arch
A Trans Palatal Arch is used in the upper arch. It is a wire which extends across the roof of the mouth and is most commonly attached to the upper first molar teeth. A TPA is utilised to provide further anchorage in the upper arch to allow for maintenance of the arch width and to maintain the position of the upper first molars.
Functional appliances can include:
Headgear
Headgear is an appliance worn at night to create special force that guides the growth of the face and jaws. It is used to move the teeth into a better position and in some cases it may prevent the need for extractions later on.
Reverse Pull Headgear
Headgear is used to help guide the teeth and upper jaw into a better position. Regular wear of your headgear achieves the best results. It is used to move the teeth into a better position and in some cases it may prevent the need for extractions later on.
Twin Blocks
Twin Blocks are a type of removable functional appliance which consists of upper and lower plates that work together to enable the lower jaw to be shifted into a more forward position. Twin Blocks will not straighten teeth, they just allow for a more functional bite by allowing the jaw to grow to its maximum potential. They are worn at a young age, while the patient is growing and in some cases prevent the need for surgery later on.
Herbst Appliance
The CBJ/Herbst appliance is used to enable the lower jaw to be postured in a more forward position. The CBJ/Herbst appliance, when used in a growing patient, encourages the lower jaw to grow to its maximum potential. A CBJ/Herbst consists of a few different components: an upper frame with an upper maxillary expander which will be cemented to the upper first molar teeth, a lower frame which will be cemented to the lower first molar teeth, right and left telescopic arms which are used to posture the lower jaw forward to the ideal position. Throughout treatment a CBJ/Herbst appliance will be adjusted according to the growth and position of the upper and lower jaws. Treatment time is approximately 12 months. Once treatment is complete, the appliance is removed braces may be placed to align teeth fully.
Quadhelix (expander)
Sometimes the upper jaw can be too narrow to fit all the teeth in, or it can be too narrow when compared to the lower jaw. A Quad Helix is used to widen the upper jaw to create space gently. It may also be used to help correct the bite at the back of the mouth.
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