Early Orthodontic Treatment for Children

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Introduction by: Dr.Neal C.Murphy,Professor of OrthodonticsSomeone once told me that the measure of a person is not what they accomplish in life but rather the influence they have on the lives of others. Approximately 35 years ago I started teaching in an effort to influence how dentists practiced orthodontics. The majority of the orthodontic profession was mainly concerned with straightening teeth in the permanent dentition and bicuspid extraction was the main technique employed when the patient presented with any overjet and/or crowding. I was initially exposed to this treatment philosophy 40 years ago but soon adopted a functional philosophy of early orthodontic treatment. Rather than focus mainly on the teeth, the functional philosophy diagnoses and treats functional problems, skeletal problems and then finally dental problems. Initially functional problems are addressed including the elimination of harmful habits and the establishment of a patent airway. This involves referral to ear, nose and throat specialists for the removal of the enlarged tonsils and adenoids. Clinicians must eliminate mouth breathing habits and establish normal nasal breathing. Habit breaking appliances such as Myobrace® and Maxillary Banded Hyrax with a crib are utilized in the beginning of treatment. The next objective would be to treat all skeletal Class II malocclusions in the mixed dentition to create a Class I skeletal malocclusion.