Sarah presented at 9 years of age, at the ideal stage for non-extraction (arch development) treatment. She was in the late mixed dentition - i.e. there were still several deciduous (baby) teeth present. The top front teeth were slightly prominent and there was some crowding present.While the upper teeth were well aligned, the crowding was apparent in the lower incisors, where one tooth was displaced inwards.

Sarah and her parents preferred a non extraction approach to her treatment and therapy therefore began with an upper removable appliance and a lower lip bumper. Night time headgear (see picture at top of the page) was used to move the upper teeth backwards. The headgear was worn for between 12 and 14 hours per day - normally from arriving home from school to getting up in the morning. Headgear, like most orthodontic appliances, is surprisingly easy to get used to and Sarah cooperated superbly with it, producing a rapid improvement.

After seven months, a considerable improvement was seen. The upper front teeth no longer protrude and there was spontaneous alignment of the lower incisors. At this stage, the spontaneous improvement in the lower incisors should be noted. The instanding lower incisor has not been touched by any appliances - yet it has slowly moved into line, as space has been created for it by the lip bumper. This is a good example of how growing teeth want to be straight and will be, if enough room is created for them.

After 15 months, all the adult teeth had erupted and a fixed brace could now be used to complete treatment.

After 4 months with the fixed brace, treatment was nearly complete.

After a total of 20 months of treatment, a perfect result was obtained.