Early Orthodontic Treatment

ChildTreatmentThe American Association of Orthodontists (AAO) recommends all children be examined by an orthodontist before seven years of age. At this age, children are actively growing, which improves the ease and effectiveness of orthodontic treatments, as well as reduces treatment time. Stability is improved because the changes made are skeletal.

Not all children need early treatment, but there are certain developmental conditions that, if treated early, can create outcomes that may not be achieved at a later age. Issues like missing or extra teeth, cross bites, open bites, crowding, large overbites and under bites can benefit from early treatment. We are now learning the significant benefits of early treatment on proper airway development, enabling us to better manage and address airway issues before they result in a lifetime of compromise.

Our Area of Expertise for Children

Most early treatments require six to 10 months with fixed appliances. In almost all cases, braces are not required during this stage. A second stage is usually required around 12 years of age, with complete braces for ideal alignment. This second phase of treatment is simpler, shorter and achieves greater results without having to remove permanent teeth in most cases.

Advantages of Early Treatment

  1. All appliances are custom fit for comfort.
  2. Precise diagnosis using the latest 3D technology combined with the experience of more than 12,000 smiling faces treated.
  3. Your child will be seen by the doctor at each appointment.
  4. Elite Smiles Chastain uses only fixed appliances, so there is nothing removable to lose.
  5. The doctor will make all adjustments at the office, nothing for you to turn or adjust at home.
  6. Most early treatments are 6 to 10 months in length, with no braces necessary. Braces are placed during the second phase of treatment.
  7. This treatment is designed to make skeletal changes which are the cause of most issues we treat (i.e.: crowded teeth are caused by small jaws not too many teeth). These skeletal changes are best accomplished from 6-10 years of age.
  8. Airway enhancement is possible.

Crossbite of Back Teeth

Crossbite can occur in the front and/or the sides of the mouth. One or more upper teeth bite on the inside of the lower teeth. This can occur with a single tooth or multiple teeth. Notice how the upper jaw can widen with this treatment.


Notice how the upper jaw can widen with this treatment.

Open Bite Phase I

Open bite is a condition in which either the front teeth or the back teeth do not make contact. It is caused by oral habits such as tongue thrust, finger sucking or when the jaws don't grow evenly.



Crowding Phase I

Crowding is the lack of space for all the teeth to fit normally within the jaws. The teeth may be twisted or displaced. Crowding occurs when there is disharmony in the tooth to jaw size relationship or when the teeth are larger than the available space. Crowding can be caused by improper eruption of teeth and early or late loss of primary teeth.



Large Overbites (Phase I)

Overbites are when the upper front teeth protrude. The most common dental accident to occur at this age is to fall and fracture these protruded upper front teeth.



Underbites (Phase I)

Underbites are when upper front teeth bite behind the lower front teeth.



Phase I and Phase II


This patient had an overbite and was crowded on the upper and lower.We created more room for the adult teeth in the Phase I treatment.


The same patient was treated with Phase II. He presented with an overbite on the left. He was treated using braces and TADS. The expansion in Phase I created room for the teeth and allowed self alignment. At the end of Phase II, both the overbite and Class II on the left were corrected.

Airway Orthodontics

OSA (obstructive sleep apnea) is defined as repeated episodes of partial or complete blockage of the upper airway during sleep. Basically, air is not clearing the throat to get to the lungs to provide oxygen to the red blood cells. Since these cells are then not fully oxygenated the brain and body do not receive enough oxygen to build and repair. In a growing child, who hopefully sleeps 10-12 hours a day, OSA can result in almost ½ the time their body is not functioning optimally due to lack of sufficient oxygen. Sleep apnea has been documented to cause cardiovascular disease, high blood pressure, neuro cognition and lipid regulation disease as well as ADHA and a host of behavioral issues.

You might ask, “What is an orthodontist doing with the airway?” With our new 3D technology, researchers are discovering a correlation between airway development and the shape of the jaws. For instance, they have found a patient with a narrow upper jaw has 25% more airway resistance than the same patient after the jaw is widened.

If the lower jaw is widened or moved forward the tongue moves forward, which increases the posterior airway. If widening the jaw improves airflow then decreasing the jaw width can decrease the airflow. That is why Dr. Sebastian recommends early non-extraction(not removing teeth) treatments, because when you extract you decrease jaw width.


These photos show the upper jaw before expansion (left) and upper jaw after expansion (right).

Did you know 80% of symptomatic airway children go undiagnosed? These children have, on average, a 226% increase in health care utilization.

Why does diagnosis not occur?

Not all children with airway issues (OSA-obstructive sleep apnea) have outward glaring symptoms. They do not have a fever so they don’t see a doctor or are not symptomatic when they go. Since we see these children regularly and have the technology to aid in diagnosis and treatment, we feel the orthodontist/pediatric dentist are ideally suited to screen patients for airway issues.

What is Obstructive Sleep Apnea?

OSA (obstructive sleep apnea) is defined as repeated episodes of partial or complete blockage of the upper airway during sleep.

Please watch the video below to see what a patient with OSA goes through during the night. This child will take a breath approximately every 20 seconds. Normally, it is less than ten seconds. Between breaths, the airway is blocked so the chest will move but no air is cleared through the throat to the lungs!

Elite Smiles Chastain

91 W. Wieuca Rd., Suite 300 • Atlanta, GA 30342Orthodontics: 404.303.7400 • Pediatric Dentistry: 404.252.5900

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