Orthodontists have the
same
goals and objectives in mind in most instances. The way they arrive at
those goals is what separates them from one another. Orthodontic treatment
in growing children can be performed early on minor problems to help minimize future treatment needs
or later, comprehensively, at a time when all of the patients needs can be addressed
(usually 11-13 years of age). Sometimes a combination of the two is necessary.
The major contributors to
the differences between orthodontists' approaches to treatment is their education
and experience. I have been in practice
since 1979 and have seen a variety of changes in the philosophy of
treatment in that time.
Our practice philosophy is
pretty simple but has arisen from my personal observation and constant
continuing education regarding the procedures we commonly employ. If
there is an obvious need for significant treatment later, we will always recommend
waiting on minor corrections until a more comprehensive correction can be done. Many orthodontists
and pedodontists (pediatric dentists) correct every minor problem as they are discovered and this makes for a
childhood that is full of orthodontic visits. If we know that a comprehensive treatment for a major problem is going to be necessary,
and it is not essential that the current problem be treated immediately, we
prefer to combine correction of minor problems with the later comprehensive
care. This not only saves the parents
money but it also saves lost time from school and work for the child and parent. Two research papers published by the National Institute of
Health in the year 2000 indicated that early treatment in mild to moderate "overbite"
cases provides no substantial benefit and, in fact, extends treatment time an average of
12 months. It constitutes a needless increase in the total treatment cost.
There are some early procedures that are critical to a good end
result because they are orthopedic in nature and affect growth. Others,
such as simple tooth alignments, can certainly wait if it is not
psychologically damaging to the developing child. I have found that early intervention (at 8-10 years of
age) as a first phase of treatment is necessary in only a small percentage of
cases.
TM
