Can we treat kids in mixed dentition with clear aligner?
May 22, 2023
The Benefits of Early Orthodontic Treatment for Kids
Can we treat kids in mixed dentition with clear aligners? That question is often asked. Will children wear the aligners? The answers: Yes and yes!
Young patients have been wearing appliances through the years and have excellent compliance. Appliances that are a lot more challenging to wear than aligners (twin blocks, Haas, split plates, quad helix, headgear, etc...).
Teeth are not selective; whether it is a primary or permanent tooth, if you apply a constant force and they are not blocked or ankylosed, they will move!
With kids, we want to prevent problems, keep space, maintain space and/or regain space that we have lost for some reason.
Preventive and interceptive orthodontic treatment is sometimes unclear because it implies that if we do it correctly and intercept a problem, there will be no need for further orthodontic treatment, which is often not true! Intercepting a problem and preventing some issues will be very helpful in reducing the severity of problems but rarely is so successful that later treatment becomes unnecessary. Our responsibility as primary care providers is to see the problems, understand the consequences they could bring and inform the parents/patients about them.
Preventive and interceptive orthodontics are essential to ensuring our kids have the best dental future possible. As dentists, we know that the earlier we can identify potential problems and nip them in the bud, our patients will be better off. But why is this so important? Let's look closer at why preventive and interceptive orthodontics benefit growing children.
What Is Preventive Orthodontics?
Preventive orthodontics is all about creating an environment where your patient's oral health gets off to a great start. It involves monitoring tooth development and jaw growth to ensure that everything stays balanced as they grow up. This can include using space maintainers to keep teeth from drifting into empty spaces left by baby teeth or using expansion appliances to make room for permanent teeth when needed.
What Is Interceptive Orthodontics?
Interceptive orthodontics focuses on correcting problems before they become more severe in the future. This type of treatment is usually done between the ages of 6 and 10 because that's when a child's mouth is still developing quickly enough for us to make changes relatively easily. It can involve anything from addressing bad habits such as thumb sucking or tongue thrusting to simple procedures like widening palates or removing teeth.
Why Is Early Intervention So Important?
Early intervention helps us prevent more severe issues from occurring in the future. By taking steps now, we can help ensure our patients have healthy mouths well into adulthood and beyond! Plus, starting treatment early means that a patient's overall treatment time could be shorter than it would be if an intervention weren't started until later in life - saving time and money!
What is essential to know is when to treat, when to wait… and when to use clear aligners!!!
Preventive and interceptive orthodontic treatments are invaluable tools for helping our young patients achieve beautiful smiles in the future! By taking a proactive approach now, we can help them avoid costly procedures in the future while also providing them with confidence-boosting results sooner rather than later! When it comes to helping kids get off on the right foot with their oral health - preventive and interceptive orthodontics are key!
In every case, when you decide to treat your young patients with phase I or age-appropriate orthodontic treatment, make sure the parents have been made AWARE of the possibilities and options for orthodontic treatment following complete dentofacial development. If you see they don't understand the problem or don't see the problem… WAIT!
Your patient and the parents are ready
You must decide what appliance you are going to use. Clear aligners? Really? Of course! Why not?
Can we use clear aligners to treat children in mixed dentition cases? What does the scientific literature say about it? Let's take a look at the scientific literature:
In their article "Comparison between clear aligners and 2 × 4 mechanics in the mixed dentition: a randomized clinical trial" published in 2022 in the Angle Orthodontist, Vinicius Merino da Silva and al. concluded that clear aligners and 2 x 4 mechanics using fixed metal brackets displayed similar efficacy and efficiency for maxillary incisor position corrections in the mixed dentition. According to their article, the choice of appliance should be guided by the clinician and family preference.
Ok, but… What is the best appliance? You might ask. The answer is the same for retention. Same for any treatment. The best appliance is the one the patient will wear!
My experience treating kids in mixed dentition with clear aligners is positive. I like it. They like it. They wear it (sometimes a lot better than their parents who are in treatment simultaneously), and they are fun to treat (they are not teenagers yet 😬).
Mechanic is mechanic. By understanding the principles of clear aligner orthodontics combined with growth and development principles, development of occlusion, you'll define the appropriate age for treatment, and you'll be able to maintain everything in place until phase II.
If you are not entirely comfortable diagnosing and treating phase I patients with clear aligners, if you are not sure how to prevent problems and prepare patients for upcoming phase II treatment, If you want to understand what to observe and monitor in mixed dentition patients and determine the right time or appropriate age for treatment, here are some options for you:
If you like online courses, we got you covered with the Preventive and Interceptive orthodontics treatments: when to treat, when to wait and when to use clear aligners. This 8h30 covers all the subjects with complete treated cases with clear aligners.
If you prefer the live in-person experience, we give a two sessions (24 CE credit hours) course entitled: Treating kids and teens with clear aligners. In 2023 the course starts in June in Vancouver (Session I), and Session II is in September.
Have fun making the move… and have fun treating kids with clear aligners 😉.