Interceptive Orthodontic Treatment

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Interceptive Ortho
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Sometimes it's 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.

Young children (age 6-9) with moderate to severe crowding of the lower or upper front teeth can avoid the removal of permanent teeth with interceptive treatment.  As the permanent teeth begin to erupt in the front part of the mouth, there may 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.  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. 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.