Ashcraft and Frazier

"Moving Teeth Changes Lives"

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When To Start Treatment

The Question

When is the right time to start treatment?

This question is often asked of us by parents, especially as they see other young children with braces.  Our specialty training in orthodontics focused on both early treatment (7-9 years old) as well as treatment starting later when the last four deciduous (baby) teeth are about ready to be lost.

Our Answer

We have been fortunate to have the opportunity to treat numerous patients with both techniques and then review them in the following areas:  finished results, length of treatment, number of appointments, broken appliances, cooperation and patient motivation/enthusiasm.  Combining this information with new wire and appliance technology from 3M/Unitech (, we have concluded that for the vast majority (~80%) of adolescents, it is best to delay treatment until most if not all, permanent teeth are in.

Why Wait

The five major reasons to wait:

  1. Decrease time in braces and fewer appointments, resulting in:
    • Less chance of enamel decalcification and root resorption
    • Less time absent from school or work
    • Less opportunity for broken appliances
  2. Facial growth is occurring more rapidly during adolescent years increasing treatment effectiveness
  3. Cooperation and understanding are better when a child is mature
  4. Completing treatment in one phase is less costly then two phase treatment
  5. Same stable finished treatment results

The most optimal time to realize these benefits will vary with each individual child, but for most children, it is usually between the ages of 11 and 12.  Orthodontic treatment begun during this window of opportunity will result in braces being on for 18-24 months instead of 3-4 years or more.

The Exceptions

There are a few orthodontic conditions that warrant an interceptive phase of early treatment. These include:

  • Creating room for crowded, erupting teeth
  • Cross bites
  • Space maintenance for early loss of a primary (baby) tooth
  • Severe jaw disharmony, so that jaw-surgery may be avoided
  • Reducing risk of trauma to protruding teeth
  • A young child who is suffering psychologically or socially

Our Philosophy

Needless to say, the timing of orthodontic treatment is an important issue that can make orthodontics either a rewarding and enjoyable experience or one that is prolonged and tedious.

The American Association of Orthodontists recommends that the initial orthodontics evaluation should occur at the first sign of orthodontic problems or at age 7.  At this early age, orthodontic treatment may not be necessary, but allows us to anticipate the most advantageous time to begin treatment.

Our Goal

We want to provide you the best treatment we can in the shortest reasonable time period and the least number of appointments.

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