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(ONLY BABY TEETH PRESENT) |
With only baby teeth present it is difficult to make meaningful changes to the positions of the teeth. Most of the treatments done at this time relate to orthopedic and/or skeletal changes. |
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( the eruption of permanent incisors starts the early mixed dentition with adult and baby teeth present) |
Crossbites, functional shifts, early signs of crowding, teeth at weird angles, missing teeth, extra teeth, abnormal jaw growth, finger and thumb sucking and self-image should be evaluated now. Sometimes treatment is started now. I defer treatment to the middle mixed dention period. Waiting for all of the incisors lets me get a better handle on the amount of crowding or spacing that may be present. Waiting also makes treatment more efficient and because we are not waiting for teeth that may need braces. For some children cooperative behavior may be difficult. I'll usually take a panoramic x-ray to look for the presence of all teeth and evaluate the timing of their eruption. |
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(The first molars have erupted and all four upper and lower incisors have erupted) |
This is an ideal time to do interceptive treatment. Tooth crowding can be evaluated, jaw growth can be assessed. This is a great age because this age range is wonderfully cooperative. Treatments done at this age include a combination of expanders, partial braces and functional appliances. |
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(It seems like a whole cascade (12 primary teeth) of teeth are being lost) |
At this time, the same sorts of treatment are done as above. However, at some point, there is a time when some back primary teeth are loose, and if a fixed expander is needed, sometimes treatment may be delayed until a few more permanent teeth erupt. |
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(girls are closer to 12-16 and boys are about 14-18) All baby teeth are gone |
The options become more limited at this time. Growth slows dramatically, the mid-palatal suture fuses, and young men and women sometimes hate the thought of having braces and are less cooperative. Problems addressed at this time are crowded or misaligned teeth, spaced teeth, impacted teeth, jaw asymmetries or misalignment. Skeletal abnormalities may need to be surgically corrected. |
| Adults
(After 16 for women and after 18 for men) The second molars have emerged, the wisdom teeth may or may not have made themselves apparent |
At this point the bite or the smile doesn't change much without some help. Functional appliances and fixed expanders are ineffective. Braces or a combination of braces and jaw surgery are the best ways to achieve a normal bite and a great smile. |
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