Early Treatment Examples

Anterior Crossbite

Patient with a Cross Bite of the front teeth in the “mixed dentition” showing the beginning recession to the lower left front tooth.

Treatment with 2X4 braces (2 braces in the back on the top and bottom and 4 braces on the front teeth, hence 2X4 braces).

The blue cement on the top of the back teeth help to open the front bite to allow correction of the cross bite.

Cross bite corrected

Upper fixed retainer, the lower will have one as well which will be maintained until all of the permanent teeth erupt. They will then be removed to allow placement of the final set of braces to align all of the permanent teeth.

Open Bite with Oral Habits

Patient with an Open Bite due to a thumb habit.

The tongue fence appliance has a duel function of stopping the thumb habit and blocking the tongue to allow the front teeth to naturally close together.

After 5 months of having the tongue fence in the front bite is almost closed.

Deep Bite

Young patient in the mixed dentition with a deep bite (lower front teeth hitting the gums behind the upper front teeth).

Deep bite corrected, now waiting for the remaining permanent teeth to erupt in order to start full treatment.

Underbite with Narrow, Upper Jaw

Young patient in the mixed dentition with an underbite and narrow upper jaw.

X-ray showing the beginning of an impacting upper left canine tooth.

Palatal expander and bite plates (blue cement on molars) in place. Braces were placed on the top front four teeth approximately 2 months after the expansion was complete.

Completion of the Interceptive treatment with both the front and back cross bites corrected.

X-ray showing the new path of eruption for the upper left canine, no longer impacting since the palatal expander was able to create space for eruption of this tooth.

Early Loss of Baby Molar

Occasionally a baby molar is lost early. If this molar is the last one in the arch the first permanent molar may move forward and block the eruption of the permanent second premolar as in this case.

You can see on the radiograph that there is not enough space to allow the eruption of the permanent second premolar.

With the use of braces the first molar can be moved back to create space for eruption of the second premolar. Preferably this should be accomplished before the permanent second molar erupts in.

Photo showing a good Class I molar relationship and space for the eruption of the second premolar.

Occlusal view showing eruption of the second premolar. This patient will be ready for full braces in approximately one year.

Gingival Recession

The crossbite in the mixed dentition can push a tooth out of position and cause gum loss.

The gum loss (gingival recession) can become severe enough for the tooth to loose support and possibly be lost.

Braces were placed to correct the cross bite and this patient received a gum grafting procedure to lift the gum tissue back to the correct position.

Impacted Permanent Tooth

If trauma occurs to a baby tooth before the permanent tooth erupts it may delay or prevent the eruption of the permanent tooth as it did in this young man.

Notice this patient is in the mixed dentition however the significant delay in eruption of the permanent central incisor necessitates early treatment.

Limited braces are placed to allow forced eruption of the permanent tooth once a brace is placed under the gums.

Impacted front tooth in place, now awaiting eruption of the remaining permanent teeth in order to start comprehensive orthodontic treatment.