Unlocking Is The Key to Success
by Dr Michel Champagne
Interceptive orthodontics (Phase I treatment) is not fully accepted in the orthodontic world. Should we look at Phase I Orthodontics as overtreatment or missing a huge opportunuity to promote growth normalization at an early age, when it counts the most. Some clinicians have only one goal i.e. a perfect static dental Cl I occlusion (perfect final dental cast occlusion). If we join this philosophy, almost all treatment can be postponed to the early permanent dentition and have a great success rate. SHOULD WE ONLY CONSIDER STATIC DENTAL CASTS OCCLUSION ? What will or should we do with early signs and symptoms of malfunction seen at a young age : swallowing and breathing problems, inadequate lip seal, multiple locks (anterior and or posterior crossbites, narrow arches, lip entrapment with large overjet, openbites, deepbites, etc.). Some studies show a 42% improvement after Phase I treatment (AJODO 2016 ;150(6) :997-1004), without even considering the effect of some maloccusion on social relationships and bullying. When enough factors are present, Phase I Orthodontic Treatment well before the end of the mixed dentition is indicated to take charge the global health of our young patients. Should we postpone treatment for 3 to 4 years in certain situations just for the purpose of a short treatment time with no consideration of the above factors…I DO NOT THINK SO.
It is my opinion, that the improvement of function and the avoidance of bullying must win over the length of treatment. Our primary goal is to lift all the locks as soon as they are seen as having a negative impact. This unlocking allows the maximisation of normal growth for that patient. Considering the above, the correction of a posterior crossbite may facilitate nasal breathing (not garanteed) as well as protecting the TMJ, mandibular repositioning may improve lipseal, improving the width of narrow arches can promote normal cuspid eruption, etc. Phase I orthodontic treatment has it’s place in our offices.