Teeth
may be aligned poorly because the dental arch is small
and/or the teeth are large. The bone and gums over the
roots of extremely crowded teeth may become thin and
recede as a result of severe crowding. Impacted teeth,
poor biting relationships and undesirable appearance
may all result from crowding.
INTERCEPTIVE
ORTHODONTIC TREATMENT: CORRECTION OF CROWDING IN YOUNG
PATIENTS
Our office philosophy is avoidance of extraction of
the permanent teeth when possible. To attain that goal,
it is sometimes necessary to remove a few baby teeth
to avoid distortion of the jaw, damage to the teeth,
improve the cleaning ability, and gain alignment of
the erupting permanent teeth. The following discussion
will help you understand the interceptive steps necessary
to help your child attain a normal development:
•
Quite often we see young children (age 6-9 ) with moderate
to severe crowding of the lower or upper front teeth.
As the permanent teeth begin to erupt in the front part
of the mouth, there will sometimes be two rows of teeth
present at the same time. Usually it is the permanent
teeth erupting to the tongue side of the baby teeth
which gives the "double row" appearance.
• The space available for alignment of the teeth
is at a maximum in the front part of the mouth at age
8-9. The mouth gets bigger to allow the molars to erupt
through growth in the back part of the jaw. At age nine,
the jaw width across the front is as wide as it will
be in the adult and any crowding present at that time
will not self-correct due to growth. Sometimes, parents
think if they wait, the mouth will grow to accommodate
the permanent teeth. Not true! What you see at age eight
is what you get later unless the space is managed by
orthodontics.
• If there is moderate to severe crowding in the
front, then sometimes we will recommend removing two
to four baby teeth to make room for the permanent teeth
to erupt. Unless one of the erupting teeth is way out
of line, the tongue pressure will usually align the
four permanent incisors within a period of 3-6 months.
Since we usually recommend removing the baby cuspids,
there is no harm in doing this procedure to eliminate
crowding.
• Having
to remove these baby teeth tells you something though!
There may not be enough room for all the permanent teeth
in the future. Early removal will allow most of the
permanent teeth to align, so the bone will not be damaged
by severely crowded permanent teeth. When the permanent
bicuspids begin to erupt around age eleven, it may be
necessary to begin treatment with braces or other orthodontic
appliances to make more room, and try to avoid having
to remove permanent teeth. We don't need to make those
decisions until we see how much room is needed later,
but it is best if we see your child on a regular basis
to evaluate the growth and development.
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