Early Orthodontic Treatment

Orthodontic Care 

also see Adult Orthodontics
For his younger orthodontic patients, Dr. Rondeau prefers Two-Phase Treatment. First, all functional problems including mouth breathing, snoring, jaw joint problems, and habits such as thumb sucking or tongue thrusts, are treated immediately. Any skeletal (bone) problems such as narrow jaws or underdeveloped jaws are also treated with functional appliances. Recessive or underdeveloped chins are consistently moved forward with functional appliances while the patient is still growing. This is more preferable than waiting until all the permanent teeth erupt and surgically moving the lower jaw forward. Once the arches are developed in Phase One and all the permanent teeth erupt, braces may be utilized to straighten the teeth in Phase Two. “The combination of these two phases of treatment ensures beautiful faces, full lips and outstanding profiles,” says Dr. Rondeau.

Parents want their children to be treated as soon as problems arise. They do not want treatment to be delayed until all the permanent teeth erupt and costs could escalate. Early treatment minimizes the time that children need to wear braces and is the treatment of choice. The ideal time for treatment is any time after age 4 when problems such as narrow jaws, a thumb sucking habit, mouth breathing or malformed jaws are recognized. Since ninety percent of the face is developed by age 12, we must treat early in order to guide the growth of our younger patients.

If treatment is delayed until all the permanent teeth erupt, this increases the incidence of extractions. It has been Dr. Rondeau’s experience that most children and parents prefer to be treated without the extraction of permanent teeth. Dr. Rondeau recognizes that most children do not like to wear cervical headgear so it is not used in his office.

The Benefits of Early Treatment Orthodontics

Children should be evaluated as early as age 5 in order to guide the growth of the child and the eruption of the permanent teeth. Early treatment can regulate the width of the upper and lower arches (jaws), gain space for the permanent teeth, avoid the need for permanent tooth extractions. Also, early orthodontics reduces the likelihood of impacted permanent teeth (avoid the “fang look”), correct thumb-sucking, and eliminate abnormal swallowing and speech problems. In other words, early orthodontic treatment can solve or minimize many existing and potential problems and prevent more complicated and costly orthodontic treatment later on. In short, the advantages of two-phase orthodontic treatment include straight teeth, confident smiles, improved self-esteem, and a healthier jaw.

Answers to Frequently Asked Orthodontics Questions

For your convenience, below we have answers to some of the more popular questions regarding early orthodontics, braces, and treatment options for children and adults.  Should you have any further questions or to schedule a complimentary consultation for you or your child, please contact us and we will schedule some time for you to visit in our London, Ontario office.

Early treatment, or Phase I, would be recommended if there are certain discrepancies in the development of the upper and lower jaws. Early treatment can correct these problems in the early growth phase of your child (utilizing a functional appliance), which develops the bone to a more normal size, to allow enough room for the permanent teeth to erupt.

  • Improve profiles, smiles and self-esteem
  • Correct harmful habits
  • Improved speech from expanding the arches and making more room for the tongue.
  • Reduction of the time in fixed braces and frequently eliminates the need for the extraction of permanent teeth.
  • Prevent the fang look. Upper eye teeth (cuspids) are the last teeth to erupt on the upper arch. If the jaw is too narrow, patient will get the fang look.
  • Prevent possibility of facial asymmetry with the expansion of the upper arch and the correction of the posterior crossbite.
  • Improves head posture which helps eliminate neck pain
  • Prevents grinding of the teeth at night
  • Improves nasal breathing
  • Prevents gum recession

Once a thorough and proper diagnosis has been made, the best appliance to be used to correct your child’s problems will be selected. A functional appliance is a tiny device designed like a mouth retainer, with micro-screws, to make the appliance able to activate and stimulate the change in bone, therefore making the jaw grow to it’s potential. The initial records and x-rays, taken at the beginning of treatment, determine growth potential.

By using functional appliances while children are actively growing, we can help them achieve a beautiful broad smile. Mouth-breathing can cause narrow arches and unattractive smiles.

Once the early phase of treatment is finished your child will be evaluated on an ongoing basis to monitor the eruption of the permanent teeth. Once the permanent teeth are all present. We will set up a consultation appointment to determine whether there is a need for braces. Usually orthodontics, which means fixed braces, does not begin until the patent has all their permanent teeth (age 11 to 13). While braces are the most popular among younger patients, they can be worn as a teenager or an adult. More adults these days are asking for braces to help improve their smile and appearance. Set up an initial screening appointment for your child today!

The area of dentistry called orthodontics involves straightening of teeth with the use of braces. Orthodontics is also indicated when the patient has a bad bite, which can make you feel self-conscious and can cause digestive or other health problems. Braces are now less conspicuous and more comfortable than ever before, due to the use of new high-performance archwires, which exert light continuous forces on the teeth. Children should have an orthodontic assessment before the age of five so that early treatment with functional appliances can reduce the time spent wearing braces.

The average length of time for orthodontic fixed braces would be 1½ to 2 years when all the permanent teeth have erupted. The treatment time obviously depends on the seriousness of the problem and when treatment is started. Our office recommends that children be evaluated before age five to see if the problem is a bone problem or a tooth problem. If the problem involves the bone, such as the upper or the lower jaw being too narrow or the lower jaw being underdeveloped, then we recommend this problem be treated immediately with functional appliances. The use of functional appliances can reduce the time the child must wear fixed braces and reduce the need for the extraction of permanent teeth. If the problem is merely crooked teeth, many times treatment will be delayed until all the permanent teeth erupt.



  • Bite problems
  • Underdeveloped Jaws
  • Deep overbites
  • Airway problems
  • Tongue thrusting habits
  • Narrow arches
  • Crowded teeth
  • Jaw joint problems
  • Thumb-sucking habits


  • Removal of adult teeth
  • Fang-like tooth appearance
  • Lengthy use of braces
  • Speech difficulties
  • Crooked teeth
  • Low Self-Esteem


Crowded teeth are caused by narrow arches. By developing dental arches at an early age we may prevent the crowding of the permanent teeth. Since 90% of the face is developed by age 12, treatment of the child’s bite problems should be corrected early to avoid more costly and lengthy treatment later on. One of the main advantages of early treatment is that it prevents the need to remove adult teeth later on.


  • Can avoid more costly treatment later by eliminating the orthodontic and jaw problems early rather than delaying treatment when the problems are more serious.
  • Improve children’s self-esteem when crooked teeth and underdeveloped jaws are corrected early.
  • Shortens the time in fixed braces. If treatment is initiated early, many times orthodontic treatment can be completed before the child goes to high school.
  • Sometimes when the bad bite is solved in Phase I the patient does not need Phase II treatment. This results in a substantial cost saving to the patient.



Early treatment should be initiated for:

  • Habits such as tongue thrusting or thumb-sucking
  • A constricted airway due to swollen tonsils or adenoids
  • Mouth-breathing or snoring problems
  • Bad bite
  • Bone problems (narrow or underdeveloped jaw)
  • Retruded upper jaw
  • Retruded lower jaw

Phase I treatment usually lasts approximately 10-12 months depending on the severity of the case. The appliance is usually active (making changes to the jaw) for 4-6 months then the appliance should be used as a holding appliance for 6 months or as a retainer to prevent any relapse in the treatment. As the permanent teeth erupt, it will be determined when it is no longer necessary to wear the holding appliance.


BRACES AGES 12 OR OLDER – Treatment Time ~ 2 Years

In PHASE TWO, teeth are straightened with braces. Braces usually take 2 years.

Most patient’s today think braces are “cool” because of all the different colours. In fact, there are more that 40 different combinations of coloured elastics, which fit over the braces to keep the wires in place. Every month the patient has their choice of coloured elastics. Most children pick the metal braces, which are much smaller today. Adults and teenagers prefer the clear braces because they blend in with the colour of the teeth and are harder to see. We have some females who prefer gold braces since they look like jewelry. The newest and latest trend is toward invisible braces, where trays that are changed periodically and move the teeth into a better position. For more information on clear braces, click here.

A clear retainer will be made to wear when your braces are removed. The roots of the teeth need enough time to settle in the bone, so it’s absolutely imperative that you follow the instructions on wearing the retainer to maintain your beautiful smile at the end of treatment.

The length of time in retainers varies depending on the amount of tooth movement that was necessary. However, as a general rule of thumb, we recommend full time wear of the upper clear retainer for 1 full year and 1 year at night only. We generally like to make the lower retainer fixed, behind the lower front teeth, and it remains in place for 3-5 years.

Exciting news regarding new clear retainers! The newest retainer now has a clear labial bow which makes the retainer practically invisible. Patients love these new clear retainers.





75% of 12-year-olds need orthodontic treatment. By age 12, 90% of the child’s face has developed. By guiding facial development earlier, by using functional appliances, 80% of the treatment can be corrected before the adult teeth are present.


Younger children between ages 8-11 are often more cooperative than children 12-14.


Children that start with Phase One treatment with functional appliances will spend less time in fixed braces when the adult teeth come into the mouth.


Almost 50% of children who need orthodontic treatment due to a bad bite have underdeveloped lower jaws. Functional appliances can reposition the lower jaw forward, improve the child’s profile and correct the bite problems in 7-9 months.


Many children with narrow jaws, deep overbites or receding lower jaws have unhealthy jaw joints which can cause:

  • Headaches
  • Dizziness
  • Fainting
  • Difficulty opening jaw
  • Neck Pain
  • Ear aches and ringing in the ears
  • Clicking or locking jaw
  • Facial pain

Twin Block – Moving the Lower Jaw Forward

Treatment Time ~ 7 Months

Early use of functional appliances such as the Twin Block appliance that moves the underdeveloped lower jaw forward to its correct position can often prevent or eliminate TMJ or jaw joint problems as listed above (headaches, neck pain, ringing in the ears, dizziness, etc).

The Rick-A-Nator appliance is also an excellent functional appliance to move the lower jaw slightly forward and correct a deep overbite.  Children with deep overbites often have headaches which can be eliminated with the Rick-A-Nator.

Below is a case featuring the Twin Block.

Moving the Lower Jaw Forward in 7 Months



Fixed orthodontic appliance. Moves lower jaw forward which improves the profile. Corrects the overjet and overbite. Healthy jaw joints and eliminates headaches.

Rick-A-Nator – Moving the Lower Jaw Forward

Treatment Time (Rick-A-Nator-6 Months, Fixed Braces 12 Months)

The Rick-A-Nator appliance is also an excellent functional appliance to move the lower jaw slightly forward and correct a deep overbite.  Children with deep overbites often have headaches which can be eliminated with the Rick-A-Nator.  The Rick-A-Nator is a fixed orthodontic appliance that moves the lower jaw forward, which improves the patient’s profile. It corrects the overjet and overbite. Healthy jaw joints and eliminates headaches.

Below is a case featuring the Rick-A-Nator.


Mouth-breathing can lead to orthodontic problems as well as other problems such as lack of oxygen and poor sleep habits. This leaves children prone to daytime fatigue, inability to concentrate in school and headaches. Some children stop breathing at night (sleep apnea) which research shows can be linked to a condition known as Attention Deficit Hyperactivity Disorder (ADHD). These children are often difficult to handle in school as they can become hyperactive and aggressive. These children are often prescribed strong medications. Literature has shown that the solution would be to expand the dental arches with functional appliances and to remove enlarged tonsils which are obstructing the airway. This results in increasing the level of oxygen in the blood which helps prevent ADHD and sleep apnea.


Deep overbites and receding lower jaws may cause earaches, stuffiness or ringing in the ears. If infections have been ruled out, functional appliances can be utilized to correct the deep overbite or gently move the lower jaw forward can often eliminate ear pain or stuffiness in the ear.

Deep overbites and receding lower jaws may cause earaches, stuffiness or ringing in the ears. If infections have been ruled out, functional appliances can be utilized to correct the deep overbite or gently move the lower jaw forward can often eliminate ear pain or stuffiness in the ear.


Narrow jaws can confine the tongue and interfere with normal speech. Functional appliances can expand the size of the jaws which can make more room for the tongue and enhance a child’s ability to speak normally.


Orthodontics is usually our Second Phase of treatment, following the use of functional appliances. The braces would now be placed to move the teeth into alignment to support the development of the bone achieved in the first phase of treatment. The second phase of treatment is initiated when most of the permanent teeth have erupted.

Braces are the small, square metal attachments (called brackets) that are bonded with special orthodontic adhesive to the teeth. There is a small slot in the in the middle of the bracket into which the orthodontic wire fits. In order to hold the wire in place, small tiny elastics are wrapped around the outside of the braces. It is the combination of the braces, the wire and the elastic that help the tooth move into is proper position.

To help make the wearing of braces more fun, patients have a choice of at least 40 different colored elastics.

The model below has red and green elastics in keeping with the Christmas spirit.


This phase of treatment usually last between 12-24 months depending of the amount of tooth movement necessary to align the teeth and to establish a proper bite. It is important to remember that treatment time is estimated. Dr. Rondeau has specific treatment goals in mind and will usually continue treatment until these goals have been achieved. Patient cooperation is the best way to keep on time with your treatment. Be sure to take care of your braces and to wear your rubber bands as instructed and we will both be able to achieve our desired result.


After phase II is completed it is necessary to wear retainers to hold the final result. The great part about our retainers is that they are virtually invisible which helps guarantee patient acceptance and ensures they will be worn at the appropriate times.