When finding the best two-phase orthodontics in NYC for your child, you want a doctor who can identify orthodontic issues early, because this is the easiest time to correct most growth problems. Having options for early intervention means less time in appliances and more time just being a kid! Dr. Lena Sapozhnikoff works with young children and their families to ensure that children’s craniofacial growth supports their happiest, healthiest smile, breathing, biting, chewing, and swallowing.
When Dr. Lena notices crowding, for example, that is a sign of underdevelopment, where the bone hasn’t achieved sufficient growth due to issues like diet, tongue-tie, or allergies and environmental irritants. If there’s no space between the baby teeth at this age, it’s an indication that there won’t be enough space for the adult teeth to grow properly.
Crowding, along with other indicators of underdevelopment, such as mouth breathing or difficulty chewing and swallowing, might suggest the craniofacial bones could use some growth encouragement. Early intervention can prevent problems down the road like malocclusion, undersized jaws, and sleep apnea.
“What we do is help kids grow,” says Dr. Lena.
Why Start Orthodontic Treatments Early?
The American Association of Orthodontics recommends starting with your child’s first visit to the orthodontist at the age of seven, but we suggest you see an orthodontics-informed dentist like Dr. Lena even sooner.
Dr. Lena explains: “By the age of six, 90% of craniofacial growth is complete, so everything we do after that is corrective.” Dr. Lena and her team are dedicated to creating preventative solutions that give children beautiful healthy smiles that last a lifetime.
Two-Phase Pediatric Orthodontics
There was a time, not very long ago, when pediatric orthodontics was primarily for teens. Today’s modern orthodontics, however, can make the overall treatment a lot easier on kids if we begin to address their facial growth issues earlier in childhood. Some children can benefit from what’s called two-phase orthodontics. Signs that your child may benefit from it include:
- losing baby teeth before age 5
- bite that doesn’t come together properly
- big overjets
- underbites
- crossbite
- deep or open bites
- mouth breathing
- snoring
- teeth grinding at night
- problems with chewing or biting
- lack of spacing between primary teeth
- crowded or protruding primary teeth
Dr. Lena can identify whether your child has any bite or structural issues that need to be addressed with an early phase of orthodontics.
Phase 1 Orthodontics
Phase 1 orthodontics typically begins between 6 and 9 years old when children are losing their baby teeth and permanent teeth are beginning to emerge. However, age alone is not an indicator for starting treatment. Some kids may need expansion as early as 3 years old. What changes is the turning protocol for the expansion appliance. Redirecting unfavorable growth patterns early will establish a healthy foundation later in life. Using age-appropriate appliances and developing healthy habits can build a functional bite and guide those teeth proactively to their ideal locations.
This gives kids a great start on a healthy smile for life. It also can eliminate the need for tooth extraction or other orthodontic surgery later in life. That means more oral comfort for kids and less money spent by caregivers. It’s a win-win.
Rapid Palatal Expansion (RPE)
Rapid Palatal Expansion, or RPE, is a Phase 1 treatment designed to provide a healthy foundation for your child’s permanent teeth. If their primary teeth are crowded, then we’ll need to make more space to accommodate them. The go-to treatment here used to be extracting permanent teeth in adolescence to make more room before braces, but RPE addresses the real issue of an underdeveloped jaw and creates space for all of your child’s teeth.
To create that space, we affix an expander to the upper back teeth that fits on the roof of your child’s mouth. The parent or caregiver will turn a key periodically on an expander that slowly spreads the maxilla, or upper jaw, over about two months. (The rate of turning depends on the type of the expander and age of the child.) The body quickly heals the space created between the two halves of the palate with new bone tissue over the following months, and the end result is a more spacious jaw ready to support healthy adult teeth. RPE can benefit your child by:
- creating more room for incoming adult teeth
- enhancing facial esthetics
- improving nasal breathing due to increased nasal volume*
- creating more room for the tongue
- being well tolerated by kids
- naturally reducing the size of tonsils and adenoids
- producing stable long-term results
*Incidentally, around 66% of sleep disordered breathing pathology is solved by addressing nasal breathing.
Miniscrew-Assisted Rapid Palatal Expansion (MARPE)
We see plenty of adolescent patients who might have benefited from undergoing earlier Phase 1 Orthodontics but didn’t for one reason or another. Not to worry! We can still help them have a functional bite and great smile.
Just like for our younger patients, we’ll recommend rapid palatal expansion for these adolescents. They require a slightly different device due to their less pliable palate. Instead of affixing only to the upper back teeth, a MARPE expander is also secured to the palate itself with tiny pins that remain for the duration of treatment.
Similar to RPE, this expansion creates space in your child’s mouth for all of their permanent teeth. It also offers the additional benefits of improved airway function and improved smile and facial esthetics. MARPE is usually followed up with braces or Invisalign to straighten the teeth and close any gap created by the palatal expansion and fully align the teeth.
The most common version of MARPE used for young patients is MSE or Maxillary Skeletal Expander.
Other Phase 1 Orthodontic Treatments
Other Phase 1 treatments we may explore to help proactively guide your child’s permanent teeth and set them up for success include:
- temporary braces or Invisalign FirstTM
- lower expander
- growth-guidance appliances
- dietary changes
- eliminating obstructions, such as tonsils and adenoids
- myofunctional therapy to help the jaws develop *
*Dr. Lena works with many myofunctional therapists in the area and out of state.
“The goal is, by the age of six or seven, your child will have enough room for their adult teeth to grow in comfortably.”
Sometimes, it may take more than one palatal expander to get the child’s jaws to the right size and shape. This can be determined during the orthodontic assessment visit, from the detailed records Dr. Lena will gather and analyze prior to discussing your child’s treatment recommendations.
Phase 2 Orthodontics
Like Phase 1, the second phase of two-phase orthodontics is not necessary for all patients. It is possible that the proactive guidance of Phase 1 was all your child needed. If your child does require a second phase of orthodontia, Phase 1 will have laid the groundwork, and Phase 2 will be faster and easier on your adolescent than if they hadn’t received Phase 1.
Straightening Teeth
Braces or InvisalignTeenTM are the most common Phase 2 treatments because this phase is about moving permanent teeth to their ideal positions and helping lower jaw growth. Phase 2 comprehensive orthodontic treatment focuses on fine-tuning individual tooth position, improving the bite and jaw relation and creating a beautiful smile that will last a lifetime. If the teen never had expansion or had insufficient expansion, MSE (MARPE) expander may be used in conjunction with braces or Invisalign.
Other functional appliances such as Invisalign MA, Forsus, TwinForce Bite Corrector and rubber bands are often necessary to improve the position of teeth and jaw relationships.
Begin a Treatment Plan Now!
No matter what your child’s age and what their orthodontic situation may be, reach out to Dr. Lena Sapozhnikoff to begin a conscientious treatment plan for two-phase orthodontics in NYC.
