The reality of early orthodontic therapy : Ireland's Dental Magazine

The reality of early orthodontic therapy

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For more than half a century the profession has been divided over the issue of early interceptive orthodontic therapy versus delaying treatment until the patient is in the permanent dentition. In my experience it is not an issue of early versus later treatment, but rather evaluating the true underlying cause of the malocclusion in question. If, for example, the patient is experiencing an imbalance in normal skeletal growth then early interceptive orthopaedic therapy is the treatment of choice.

Unfortunately, the dental literature is full of “valid research” proving early interceptive orthodontic is of no value. The documented proof is that one can take a Class I Division One malocclusion, extract bicuspids in both the mixed dentition and the permanent dentition, and obtain the same clinical results. What this research actually proves is the same incorrect diagnosis and treatment creates the same clinical result regardless as to when it is performed.

The Meredith & Rubin study of cranial facial growth showed that 40 per cent of facial growth occurs by four years of age, and more than 90 per cent by nine years of age. The classic view of this study is to consider all malocclusions to be dental in origin, and only minor tooth movement can be initiated until the patient matures into the permanent dentition at around age eleven. Therefore the patient has less than 10 per cent of the growth potential remaining when fixed orthodontic is initiated.

This is a gross misinterpretation of the Meredith & Rubin study.

The study actually proves that malocclusions caused by incorrect growth should be treated as early as they can be diagnosed. If left untreated one can expect to see 90 per cent of the damage to natural facial balance by age nine.

Unfortunately, doctors treating children are forced to go outside of the teaching institutions that are dominated by classic archaic orthodontic concepts in order to obtain the appropriate information.

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