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You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

• Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

• Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

• Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Byron Diehl at our Redlands, CA office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

Orthodontists like Dr. Byron Diehl recommend a first orthodontic visit and evaluation for your child around the age of seven. We will evaluate your child’s jaw and facial development and make sure that there is enough room in the mouth for the permanent teeth when they arrive. One of the recommendations we might make for early treatment is the use of a palatal expander. If you are unfamiliar with this device, let’s take a closer look at why it’s necessary and what exactly it does.

Why do we recommend the palatal expander?

There are two dental arches, composed of the upper and the lower teeth, in your child’s mouth. This arch-shaped design is meant to accommodate all the permanent teeth. Further, when the upper and lower teeth meet, they should result in a healthy occlusion, or bite.

Sometimes, the upper dental arch is simply too small to accommodate all of your child’s permanent teeth, leading to crowding, extractions, and impacted teeth. Also, a too-narrow arch can result in a crossbite, where some of the upper teeth bite inside the lower ones. An improper bite can lead to problems such as TMJ (temporomandibular joint) disorder, improper wear and stress on teeth, certain speech difficulties, and other potential complications. The palatal expander was designed to prevent these problems from occurring.

What is a palatal expander and how does it work?

The expander itself is a device that increases the size of the upper dental arch. Before your child’s bones are finished growing, the space between the two bones of the upper palate is filled with cartilage. This tissue is flexible when children are young, but gradually fuses solidly into place by the time they are finished growing (usually in the early to mid-teens). If the arch can be widened to accommodate the emerging permanent teeth, or to reduce malocclusions, this improvement can also affect the need for, and length of, future dental work.

There are several types of expanders available at our Redlands, CA office. These are custom-made appliances, commonly attached between the upper teeth on each side of the jaw. The two halves of the device are connected with a screw-type mechanism that can be adjusted to widen the upper palate and dental arch with gentle pressure. This is a gradual process, with small adjustments usually made once or twice a day to slowly move the bones further apart. As weeks go by, you will notice a successful change in the spacing of the teeth. Your child might even develop a gap in the front teeth, which is normal and will generally close on its own.

If you would like more detailed information, talk to Dr. Byron Diehl about the palate expander. We can tell you what to expect from this treatment if we think it is best for your child’s unique needs, and how to make it as easy as possible for your child. Our goal is to provide your child with the healthiest teeth and bite possible, always making use of treatments that are both gentle and effective.

Perhaps you are already planning for the years when your teenager will need orthodontic work. But hearing that your seven-year-old would benefit from orthodontic treatment? That might come as a complete surprise! It’s a recommendation with real benefits, though—early intervention can save children from tooth and bite problems now, and even simplify their future orthodontic care.

Treating young children for orthodontic problems is called “interceptive orthodontics.” When the permanent teeth start arriving, there might be problems with spacing, bite or protruding teeth. Often, treatment while the bones are still growing is the best way to prevent more serious problems later.

We recommend that your child have an orthodontic consultation with Dr. Byron Diehl around the age of seven. This exam is especially important for children who may have been thumb suckers or used a pacifier after the age of three, or if you notice obvious teeth, speech or bite issues.

• Crowding and Spacing Issues

Teeth are arranged in two crescent shapes called arches. When the arch of your child’s mouth is small, the permanent teeth can become very crowded as they erupt. Formerly, teeth were removed to make more room. Now, early use of a palatal expander can enlarge the upper dental arch in order to help the permanent teeth come in without crowding. The need for future tooth extraction is reduced, and there is a better chance for correct spacing and alignment with early treatment.

On the other hand, when a child loses a tooth too soon, too much space left between baby teeth can also be a problem. The remaining teeth can shift, leaving the wrong place open for the adult tooth to come in. We might recommend a space maintainer so that there is no shifting of the teeth and there is room for the proper adult tooth to erupt in its proper spot.

• Malocclusions (Bite Problems)

Some malocclusions, like a crossbite, can be caused by problems with jaw and facial structure. Again, we might recommend a palatal expander to help the upper arch of the teeth to fit properly with the lower jaw. Problems with overbite, open bite and other bite issues can also be addressed at this age if necessary. Early care can discourage TMJ (temporomandibular joint) disorders, reduce speech problems, and improve facial symmetry. 

• Protruding Front Teeth

Teeth that protrude are much more likely to be damaged when playing or after a fall. Methods such as braces or appliances can reposition them and protect them from breaking or fracturing.

Many children will not need early intervention, and many can wait until they are older for orthodontic work. But if your young child has orthodontic problems that should be addressed, early intervention can do more than set the stage for successful orthodontics in the teen years. Talk to our Redlands, CA team about what we can do for your child. Interceptive orthodontics can protect teeth, guide jaw and speech development, modify harmful oral habits and help to adjust bite problems before they become serious—when it comes to your child’s dental health, the best solutions are early ones!

It may come as a surprise to learn that dogs, like humans, have both baby and adult teeth. Most dogs, unlike humans, have all of their adult teeth by the time they are seven months old, so it’s time to start looking after their dental health when they are still puppies.

While dogs generally don’t develop cavities, periodontal disease is the one of the most common diseases affecting dogs. Periodontal disease starts when the bacteria in your pet’s mouth form plaque. The plaque can harden into tartar, and, if plaque and tartar spread under the gum line, can be responsible for a number of serious problems. Veterinarians warn that tooth loss, tissue damage, bone loss and infection can be the result of periodontal disease. Professional dental treatment is important if your dog is suffering from periodontal disease, and your vet can describe the options available to you. But the time to act is before disease develops. Let’s bone up on some preventative care!

Brushing

There are brushes and toothpastes designed especially for your dog. Train your puppy from an early age to open his mouth to allow you to examine his teeth and gums. (This will also come in handy if you ever need to give him medicine.) Most dogs will accept brushing, and toothpastes come in dog-friendly flavors. Human toothpaste should never be used because it contains cleaners and abrasives that should not be swallowed by your pet. There are also dental wipes available that can be used once and thrown away. Your vet can advise you how to ease your pet into a brushing routine.

Gels and Rinses

Whether you rub an antiseptic gel on your dog’s teeth or squirt an antiseptic rinse into his mouth, these formulas can reduce the build-up of plaque. Not all dogs take to the taste of these solutions, but in general they are safe and effective. Ask your vet for recommendations if you would like to try this method.

Diet

Several dietary products offer anti-plaque ingredients or a kibble shape designed to reduce the formation of plaque. Talk to your vet for the best possible diet and nutrition suggestions for your unique pet.

Chew Toys

Chewing can help reduce plaque build-up if done consistently, and chew toys should be chosen for tooth and digestive safety. Some animal-based products and hard plastic toys are so rigid that they can cause damage to teeth or gums, so be sure to look for safe toys.  Dogs shouldn’t be left alone with toys due to choking or swallowing hazards—if the chew toy becomes small enough to cause choking, or your dog is swallowing large chunks that might not be digestible, time to replace it.

Your veterinarian is the best resource for maintaining your dog’s health and developing a dental routine both you and your pet can live with. When your four-legged friend goes for his next check-up, ask your vet what you can do to keep him and his smile fetching for a long, long time.