Interceptive Orthodontic Treatment is NOT “Two Phase Treatment”
Interceptive orthodontics is poorly understood by many parents. Some parents think it is just a way for the orthodontist to start treating their child earlier and earlier. It is habitually lumped together with the “Two Phase Treatment” craze that was fashionable in the past. This type of treatment had swept through the orthodontic community.
Interceptive treatment, in actuality, is a distinctive set of protocols set up to treat very specific orthodontic and orthopedic problems in the early mixed dentition. This is done to relieve pathology that can have dire consequences if left untreated. It is most decidedly not “Two Phase Treatment”. This article will review this distinct subset and its evolving protocols. Its aim is to discuss eliminating extraordinary orthodontic problems and reducing the need for extractions, canine impactions and extended treatment times.
Interceptive orthodontics has been around for quite awhile. Often it has been referred to as “everything you can do with a retainer, headgear and some palatal expansion.” This was an often used quip, when dealing with general practice residents. However, it should not be trivialized. Robery Moyers, D.D.S., Ph.D. said in 1958, “All the most difficult problems of diagnosis and treatment planning initially are the responsibility of the general practitioner”. “The greatest orthodontic mistake is not in failing to treat, but in failing to diagnose. It is the dentists duty to diagnose all dentofacial deformities at the earliest possible time.” So now we understand who should be looking for and spotting those things which, when corrected early are of great benefit to the patient.
So what is “Two Phase Treatment”? It is generally thought of as starting orthodontic treatment at age 7 or 8. Treatment would utilize headgear or a functional appliance to correct a molar alignment. Then after a few years, apply a full orthodontic regimen of treatment; followed by retention of some sort. I often refer to this as “Preventitive Orthodontics”. (putting braces on a patient as soon as possible so it prevents them from going to another orthodontist.)
The American Association of Orthodontists’ Council of Orthodontic Education defines interceptive orthodontics as; “that phase of the science and art of orthodontics employed to recognize and eliminate potential irregularities and malpositions in the developing dentofacial complex.” So in more simple words, it is the treatment to eliminate pathology or to prevent pathology from developing. And that in a nutshell is the name of the game. If there is some pathology and is causing a problem,it should be addressed. If at the time of the exam it appears to be cosmetic or that it could wait for further teeth to come in, then that is what should be done…wait.
For the past 25 years I have been teaching interceptive orthodontics at North Shore University Hospital (now Northwell Health). By this time I have it pretty much down pat. The message is: Don’t be scared to have your young ones checked. “It never hurts to look.” I never start patients too early and if they do need treatment, you will know exactly why before you leave the office.