Adolescent Treatment (Ages 11-19)

What is Adolescent orthodontic treatment?

Adolescent treatment involves the orthodontic management of a patient who has all or nearly all of their adult teeth. At this time, the patient is rapidly growing due to the adolescent “growth spurt”. Treatment during this phase involves the correction of adult tooth position to maximize the bite. More severe orthodontic problems involve skeletal disharmonies with jaw deficiency or jaw excess. These growth imbalances (sometimes with genetic etiology) can often be best corrected during this rapid skeletal growth phase using growth to assist in the correction of the bite.

Is there anything special about adult orthodontic treatment?

Yes, the jaw structure of adults is no longer growing which limits correction of certain types of bite problems. Additionally, adults are more at risk for periodontal problems and adults have more missing and damaged teeth. However, adult orthodontic patients cooperate better than their adolescent counter-parts and as a result their time in orthodontic treatment is frequently shorter.

“Before and after “ photos below are patients who were treated by Drs. Musich and Busch.

Tooth size / jaw size discrepancy

• With the replacement of the primary dentition (baby teeth) to adult teeth, tooth size / jaw size problems can become apparent
• Treatment would involve analysis of study records to determine the cause of this problem

Mandibular excess/maxillary deficiency

• Anterior crossbite (under bite) may become more apparent during this growth phase due to the rapid skeletal growth of the patient
• Therapeutic diagnosis: More severe skeletal disharmonies are managed with expansion and traction of the upper jaw to assess the skeletal response after initial treatment and elimination of tooth interferences (crossbite)
• Diagnosis and treatment planning is important to quantify problems, predict future growth, and allow timing of treatment decisions to be made

Congenital absence / traumatic loss

• Missing teeth frequently have a familial/genetic factor
• Lateral incisors are the third most common missing tooth after wisdom teeth and premolars—missing lateral incisors occur in about 5% of the general population
• Treatment often requires reopening of the space and correction of midline with braces followed by replacement of the missing tooth
• Replacement is often favorable to canine substitution because of better aesthetics, function and stability
• Replacement options include—resin bonded bridges, traditional bridges or implants

Note—Implants cannot be placed until facial growth is complete

Failure of eruption / impaction

• Occurs when a tooth becomes wedged or stuck so that no further movement is possible
• Treatment involves full braces, possible arch expansion, and surgical exposure with orthodontic traction into the arch