Timing orthodontic treatment: early or late?


The appropriate timing of orthodontic intervention has sparked considerable debate with a body of specialist and non-specialist providers wedded to the routine provision of ‘early’ treatment.

However, definitive orthodontic treatment is most commonly started in the late mixed or early permanent dentition.

This phase typically coincides with a period of maximal growth, allowing efficient correction of growthrelated occlusal anomalies; may permit beneficial use of the leeway space; and offers the availability of permanent teeth for retention of appliances and definitive correction of a malocclusion.

Interceptive orthodontics constitutes any measure performed to correct a developing malocclusion or to simplify later orthodontic care.

It has been suggested that developing problems in the mixed dentition could be fully corrected with simple interceptive treatment in 15% and improved in 49% of cases.

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Therefore, targeted implementation of simple interceptive measures is important and cost-effective with the general practitioner perfectly placed to identify and occasionally correct developing occlusal problems in a timely manner.

However, blanket prescription of early treatment either to prevent or treat a malocclusion at a young age does not appear to be indicated.

The value of early intervention to intercept localised problems has variously been reviewed; the present review will therefore focus on the relative merits of early treatment in the management of generalised malocclusion and growthrelated issues.


° onlinelibrary.wiley.com
° The official journal of the Australian Dental Association
° PS Fleming

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