Early treatment occurs when the child still has a mixture of primary and permanent teeth. The age that early treatment usually commences is between ages eight to ten, though ages can vary due to some patients with early erupting teeth and others with late erupting permanent teeth. Early treatment typically ranges from 9-18 months.
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.
Treatment options may include the Rapid Palatal Expander (RPE), Herbst Appliance, or partial braces.
Rapid Palatal Expander (RPE)
A Rapid Palatal Expander (RPE) is designed to expand the upper jaw bones and allow the upper dental arch to fit properly in relationship to the lower arch.
This is done by activating the appliance with an adjusting screw which widens it over a period of several weeks (usually between 4 – 8 weeks). Occasionally, a space will open between the two front teeth. This should close shortly after the expansion is complete.
After the jaw has widened to the correct position, the appliance then remains in the mouth for approximately nine months. This period of stabilization will help hold the jaw expansion and allow new bone formation to occur.
The RPE is not a removable appliance. It is placed on the permanent molars with an adhesive. This adhesive will help to prevent decay of the first molars and help keep the appliance in place.
The RPE appliance is not painful. However, pressure in the palate or a sensation across the nose after you turn the appliance is often experienced but will usually go away within minutes after turning. Occasionally, the metal bands that attached to the first molars might rub against your cheek however we supply wax to help ease any rubbing. You may have slight difficulty speaking at first, but you will adjust back to normal within 3 to 5 days.
Clean your appliance thoroughly after each meal with your toothbrush. As with any orthodontic treatment, avoid chewing any hard objects such as ice, and hard lollies, as well as chewing gum and other sticky foods. Such food can break the appliance or loosen the bands.
One of the most common problems that orthodontists treat is when the upper teeth protrude beyond the lower teeth. If the upper teeth and jaw are too far forward and the lower jaw is further back than it should be – the Herbst Appliance is often the ideal solution
The Herbst appliance helps the lower jaw catch up in growth to the upper jaw. It also prevents the lower jaw from moving backward while allowing the mouth to open and close normally. Typically, patients like wearing a Herbst appliance because it replaces headgear and makes it unnecessary to wear elastic rubber bands while the appliance is in the mouth. The Herbst appliance does all the work.
The Herbst appliance is usually worn for about 12 months, followed by an additional period of time in fixed orthodontic appliances (braces). The Herbst Appliance is also often worn in conjunction with an RPE (Rapid Palatal Expander).
Initially, the appliance may feel awkward and the back teeth may not fully touch. However, within a few days to one week, normal eating and function should return. Some sensitivity of the back teeth may also be experienced. This adjustment period is to be expected and should last for a few days to a week.
If a patient has an isolated orthodontic issue such as crowding or spacing, a deep overbite or open bite (lack of contact between front teeth), concerning only one or two teeth, then a patient can be treated with partial braces. Also known as Limited Treatment, this treatment typically requires less time in treatment as the orthodontist is only correcting an isolated issue.
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