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Non-extraction treatments
Summary
Use of modern techniques makes it possible to treat most orthodontic problems without the extraction of adult teeth. For this to succeed, patients must be seen early enough - by 9 or 10 years of age - so that treatment can be carried out while there are still some baby (deciduous) teeth present.
Background Tooth extraction has never been the most popular procedure for either patient or Dentist. It has been realised, in recent years, that many extraction cases have faces that have not benefited from the loss of adult teeth - the facial profile and breadth of smile may sometimes suffer in extraction cases where the starting profile was not protrusive. In the USA, most Orthodontic cases in the average practice are treated non extraction. In this country it is around 40%. A much greater emphasis has long been placed on "the California Smile" in the States, with a broad dentition and prominent smile. To be effective, non extraction treatment (arch development) has to start in the late mixed dentition, before the last baby teeth are shed. Typically, this will be at around 9 or 10 years of age. If all baby teeth have been lost (around 11 years), then it is usually too late for this type of treatment, since the opportunity to influence important aspects of facial growth has been lost. At Chapel Road Orthodontics, Dr Horobin uses a particular type of arch development, which is well tried and highly successful. The Appliances We Use
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 Treatment is completed with fixed appliances. These apply detail to the position of the teeth - a process which only takes a few months, as they are already almost in their ideal positions. |
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Non-extraction, arch development treatments are carried out on a private basis only. If you are interested in this approach to your child's orthodontic problem, be sure to mention this at your initial consultation. Why are my child's teeth so crowded ? This is a question which has fascinated me for many years and so I will take a few lines to answer it. Dental malocclusion (crowded and twisted teeth) is a modern problem. It has only existed, to any noticeable extent, since the industrial revolution. It joins a long list of modern conditions - like asthma and heart disease - that simply didn't exist before modern civilisation.
These Orcadian skulls were all about 5,000 years old and to the eye of an Orthodontist, there was one quite extraordinary thing about them - they almost all had perfectly straight teeth! Yet numerous recent surveys have shown that about 60% of modern children need orthodontic treatment for crowded and crooked teeth. Why the difference? After all, we are genetically identical to both Neolithic and Elizabethan people. I believe the answer is very simple - diet and air pollution. Human jaws are designed to work hard, grinding and chewing at rough, semi-prepared food. Burger and mash just isn't the same! Developing jaws, that are not exercised much, do not grow as large or as strong as they were designed to. Because of this, the teeth become crowded. Air pollution, which never existed until recently, irritates the air passages, causing asthma (another uniquely modern complaint) and mouth breathing. So that is why it happens. Sadly there is nothing much we can do about this - I can't see children being keen to give up their burger buns for coarse, stone ground, unleavened bread! This does, however, help to explain why non extraction / arch development treatment works so well.
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An upper arch expansion plate, called an ELSAA (Expansion and Labial Segment Alignment Appliance), is used to widen the upper teeth, particularly where the upper jaw is excessively narrow.
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