The right time for starting orthodontic treatment

Orthodontists often provide their young patients and parents with confusing information about the right time for starting orthodontics. Some colleagues recommend starting with orthodontics when the kids are at preschool age or at primary school – referring to a developmental stage when kids have their primary dentition.

Basically, it’s very simple: The permanent dentition should be treated orthodontically, whereas the primary teeth fall out anyway and therefore their orthodontic treatment is generally questionable. This is the reason why almost all over the world it’s of common use to start orthodontic treatment when the patients’ permanent dentition is present. This is generally the case when kids are 11 – 12 years old. Orthodontists who want to treat their patients in an honest and modest way start treatment at that age.

Beside the logical conclusion of avoiding any efforts of treatment on the primary dentition, there’s even another reason why you should start with orthodontics in the early permanent dentition. All of the tooth movements benefit from the adolescent growth spurt – you can handle them in a quick and elegant manner. It’s another hint for avoiding orthodontic treatment before the age of 10 and waiting patiently until kids are 11 – 12 years old. This patience is the basis for a huge profit: The young patients and their parents are rewarded with short and smooth treatments and finally with a reduction of costs.

In Germany early orthodontic treatment predominates

It’s interesting to recognize that in a wealthy industrial country like Germany breaking the simple rules for an ideal start of orthodontic treatment is taken as a matter of course. German orthodontists mainly stick to the outdated model of early treatment. Most of the colleagues try to recrute young patients favourably as soon as they enter their practice. This nonsense is justified on the basis of two pretexts: On the one hand treatment would be easier because of its early start on the other hand malocclusions would be getting worse without any orthodontic intervention for primary school children. This could only be avoided by an early treatment. Propaganda for early treatment is summarized in the slogan “the earlier the better“. Well, why don’t we start their orthodontic treatment in utero – in their mother’s womb? Even less effort would be required then, right? In contrary, scientific data prove: The earlier you start with orthodontics the longer is the treatment duration and the higher are the costs. Furthermore it’s proven that children’s malocclusions when they are at the age of 6 – 12 don’t change significantly. This is further aggravated by a high probability of new diagnostics and therapy planning during treatment leading to higher costs and a greater burden on patients caused by an early treatment – all given facts contradict the early orthodontic treatment.

In general, starting orthodontic treatment in the early permanent dentition when kids are aged 11 – 12 is the scientifically proven gold standard. The true mystery why Germany of all countries is a stronghold for early orthodontics can be revealed easily. In Germany there are no fixed prices for orthodontics but services are paid individually. Those orthodontists who perform the longest and most complex treatments seem to act wisely when it comes to business. Therefore it’s none of a surprise that in other countries orthodontic treatment duration takes 1 – 2 years whereas in Germany it takes 3 – 4 years. This is further aggravated by using outdated removable braces during most of the early treatments – these are hardly in use internationally, they are neither scientifically investigated nor continually developed, because fixed appliances are more efficient, profitable and patient-friendly. Despite their inferior quality removable appliances are the gold-dropping donkeys of German orthodontists, because there’s no other dental technique which offers such high profits than these simple and easy-to-handle removable appliances. When your orthodontist tells your parents about starting orthodontics “the earlier the better“ he hasn’t got on his mind to improve your individual treatment but to follow his own economic interests.

A tip for parents: The later orthodontic treatment starts, the better for your children

Parents can only be advised to resist the hinting whispers of starting early treatment of their primary school children – although they seem to appear quite plausible. More than ninety percent of the children with orthodontic treatment indications are best served when orthodontics starts at the age of 11 – 12. Exceptions are crossbites of front teeth, total lateral crossbites with lateral displacement of the lower jaw and some other rare findings. All the other medical indications don’t benefit from an early orthodontic treatment, but have to pay the price later. The simple but efficient rule is to wait until the early permanent dentition is established before orthodontics gets started.


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