Early Treatment



The American Association of Orthodontists (AAO) recommends that each child first be examined for orthodontic problems by age 7. The gold standard for starting orthodontic treatment (braces) is when all of the permanent teeth are fully erupted. However, university studies show that a patient can significantly benefit from correcting the following 4 orthodontic problems prior to the eruption of all permanent teeth:

  • Anterior Crossbite
  • Posterior Crossbite
  • Severe Crowding
  • Flared Upper Incisors

Some dental practitioners claim that utilizing expansion appliances in children early (age 4 - 11) can eliminate the unnecessary extraction of permanent teeth. There is no basis for performing expansion therapy in the mixed dentition of patients who do not have posterior crossbites.* Therefore, Dr. Cardot does not recommend expansion therapy in the absence of a posterior crossbite.

Some dental practitioners claim that Phase 1 treatment (age 4 - 11) will control the growth of the jaws, eliminate bite problems, prevent the extraction of permanent teeth, and eliminate the need for traditional braces (Phase 2 treatment - age 12 and over). University studies show that most patients do not significantly benefit from two-phase treatment.** Two-phase treatment increases the total time the patient is in braces and increases the total cost. In patients who receive two-phase treatment vs. adolescent treatment (age 12 and over), there is no difference in the smile, the bite, the need for extractions, or the need for eventual jaw surgery.*** Dr. Cardot does not routinely recommend Phase 1/Phase 2 treatment.

When orthodontic intervention is necessary but not at the time of the first visit, Dr. Cardot will continue to monitor the patient’s growth and development. For an orthodontist, knowing when to do treatment is important, but even more important is knowing when not to do it. Please call Emily to schedule your complimentary consultation.

*Gianelly, A. Rapid palatal expansion in the absence of posterior crossbite. American Journal of Orthodontics.
**Ghafari, J. The early treatment of Class II, division 1 malocclusions: a randomized clinical trial. University of Pennsylvania, American Journal of Orthodontics.
**Johnston, L. Is Timing Really Everything? University of Michigan.
**Keeling, S. Skeletal and dental changes after early Class II treatment. University of Florida, American Journal of Orthodontics.
**Tulloch, J. Outcomes in a 2-phase randomized clinical trial of early Class II treatment. University of North Carolina, American Journal of Orthodontics.
***Ackerman, M. Evidence-Based Orthodontics for the 21st Century. Journal of the American Dental Association.