The Importance of Interceptive Treatment

The thought process as a pediatric dentist sitting down to evaluate a patient may be different than that of a general dentist performing an oral examination on his/her patient. The majority of the time several assessments are being performed in a matter of minutes. One observation preformed is the occlusion. Evaluate if any of the following are present: habits, deep bite, open bite, crowding, crossbites (either anterior or posterior), congenitally missing teeth, supernumerary teeth and/or trauma.

If any of these dental concerns exist, then the determination is made as to whether or not intervention is warranted, to allow the most favorable succedaneous tooth eruption pattern. If making changes is necessary or in the patient’s favor, there is another aspect to consider. Every individual is evaluated for their own appropriate treatment time; in order for one to be ready for treatment look at the dental age, chronological age, and then just as importantly, the psychological age. Chronologic and dental ages can be similar in many patients; however, psychological age varies vastly between patients.

Knowing when to treat for the most favorable and most acceptable treatment experience should be a priority. Starting slowly, or at an age a little later than optimal but still prior to full permanent dentition eruption, can be very beneficial. Interceptive orthodontics, early treatment or Phase I treatment are all names for the same orthodontic care. The main goal is to provide assistance in creating dental arches that are able to accommodate all the permanent teeth once they erupt. By intervening and developing the maxillary and mandibular arches, the percentage of multiple permanent tooth extractions is greatly reduced.

The esthetic lip line or profile will end up fuller and, as time goes by, a much more favorable look for the patient will result. The following case demonstrates the benefits of beginning Phase I orthodontics at a slightly later dental age and chronologic age due to the patient’s psychological age not being ready. This patient’s treatment continued to a complete Phase II avoiding any extractions even though all four permanent cuspids were blocked out.