While there are many orthodontic problems that orthodontists agree are best treated after all permanent teeth have come in, early treatment can be in a patient’s best interests if their problem is one that could become more serious over time if left untreated. The goal of early treatment is to intercept the developing problem, eliminate the cause, guide the growth of facial and jaw bones, and provide adequate space for incoming permanent teeth. A patient may require a second course of treatment after all permanent teeth have come in to move those teeth into their best positions.
The kinds of problems orthodontists may recommend treating while a child still has some baby teeth include:

• Underbites – when the lower front teeth are ahead of the upper front teeth
• Crossbites – when the jaw shifts to one side
• Very crowded teeth
• Excessively spaced teeth
• Extra or missing teeth
• Teeth that meet abnormally, or don’t meet at all
• Thumb-, finger-, or pacifier- sucking that is affecting the teeth or jaw growth

Some of these orthodontic problems are inherited, while others may result from accidents, dental disease, or abnormal swallowing.

Early orthodontic treatment can take many forms. The orthodontist could prescribe a fixed or removable “appliance” – a device used to move teeth, change the position of the jaw, or hold teeth in place in order to bring about desirable changes. Sometimes no appliances are necessary. Rather, removal of some baby teeth may help the permanent teeth erupt better. The extractions will be timed to take best advantage of a patient’s growth and development.

Regardless of how treatment goals are reached, the bottom line is that some orthodontic problems may be easier to correct if they are found and treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.