Adolescent Treatment

More adolescents than ever are receiving orthodontic care and for good reasons. In addition to aesthetic improvement, The American Association of Orthodontists estimates that as many as 50-75% of the population could benefit from orthodontic care to correct improper placement or other orthodontic conditions. Many factors must be taken into consideration when determining not only the need but the treatment plan for adolescents regarding orthodontic treatment.


When should a child be evaluated for orthodontic care?


It is recommended that an orthodontic evaluation is performed no later than the age of seven due to growth issues. The reason that seven is an important age is that it is a time when the first molars erupt, and it is possible to determine the establishment of the posterior occlusions. At that time, it is clinically possible for dental health professionals to determine and evaluate the transverse and anteroposterior relationships regarding occlusion, and to diagnose the presence of any cross bite or functional shifts. It is also an ideal time to detect alignment issues such as deep bites, crowding, open bites, detrimental habits or jaw discrepancies.


One-Phase Versus Two-Phase Treatment Plans


One-Phase Treatment Plan


There are various orthodontic therapy options that an orthodontist may employ, including one-phase and two-phase treatment plans. A one-phase orthodontic treatment course will generally take anywhere from two to three years. The goal is to move teeth incrementally into proper alignment using fixed orthodontic appliance options. A one-phase approach is generally considered when all permanent teeth have erupted. That provides the clinician a concise and clear evaluation of growth and leads to better predictability of treatment outcome. A one-phase approach often involves the need for extraction therapy and may not account for profile or facial concerns as in-depth as a two-phase treatment course.


Two-Phase Treatment Plan


A two-phase therapy approach involves the use of early intervention for patients who exhibit a moderate to more severe malocclusion, or overbite. When more corrective and complex issues need to be addressed, the treatment process is broken down into two phases instead of one. The first phase generally lasts anywhere from six to fourteen months.


The goal of phase-one is to use various appliances that help to correct skeletal imbalances, crowding, oral neuromuscular problems and poor oral habits, such as finger sucking. Different tools that may be used include rapid maxillary expansion appliances, lip bumpers, headgears and functional orthopedic appliances. Phase-one is important for those who need to maximize the advantages of growth as means for prevention of a worsening condition.


Phase-two consists of a fixed appliance, which is applied later on after growth has occurred and primary issues have been addressed and resolved. For both one-phase and two-phase treatment plans, the use of fixed appliances, specifically orthodontic brackets, bands, arch wires, and o-ties, are used to exert the appropriate amount of force to the teeth to realign them into proper placement.


Adolescence is the perfect time for patients to initiate orthodontic care. Various orthodontic treatment options are crucial for healthy long-term dental outcomes. To maximize the efficacy of orthodontic treatment options, an evaluation at the appropriate age of seven is highly recommended to develop an effective treatment plan for the patient.