Elements of decision to the orthodontist before starting treatment


Each orthodontist will favour a specific element in his treatment decisions. Dr Alexandrian’s decisions are focused on 2 strong objectives in her practice : short treatments and no extractions.

THE PROs for starting treatment young (7-8) with still some baby teeth :

  • patient’s compliance is good (easy age, no opposition to parents neither feeling uneasy)
  • avoid increased growth discrepancy between jaws
  • certain malocclusions such as anterior open bite can be corrected in a much more stable way
  • oavoid irreversible events (breakage, loss of teeth)

THE CONTRAS for starting treatment when all permanent teeth aren’t yet there :

  • there is a risk of overtreatment (certain misalignment improve by themselves with growth between 8 and 10)
  • some of patient’s motivation has been used, so when we suggest to finish correcting his teeth being teenager while he already has had early treatment, he finds treatment long and might be less compliant than if anything had been done before
  • saving treatment time for Phase II treatment is not guaranteed. 16 teeth come out between 10 and 12. Therefore early treatments should be done only when being sure that it saves time for later on.

Average treatment time with braces in our clinic is 18 months. It isn’t always sure that 6 months treatment at an early age will reduce same amount of time from  treatment time with permanent teeth.

All is a matter of guessing about growth direction, case complexity, risk for aggravation, and patient’s compliance throughout time.

Orthodontist doesn’t know it all. Nature has its own ways at times: late tooth eruption, unpredictable heredity, sudden teenage rebellion with compliance loss.

Even if half of children don’t need any orthodontic treatment, it is wise to check up with an orthodontist around 7-8, just to make sure you do not miss out on something, and to follow up once a year that everything turns out well.

In case a treatment is needed, success relies 90% on patient’s compliance: better to start when best for him and finish before 15-16, being a harder time for him!

Therefore VIGILANCE and professional DISCERNMENT are recommended.

This website gives access to general information about orthodontic treatments. It is not meant to replace personal patient / practitioner relationship that you will get in our clinic.