The patient, regardless of age, that has a deviation from normal occlusion as seen by the parent or the regular dentist should be examined for possible orthodontic help. Timing is important. Some orthodontic treatment can be done prior to the eruption of any permanent teeth. Other interceptive treatment can and should be done during the mixed dentition.

Orthodontic procedures can be done for children before the permanent teeth have erupted. These procedures may be needed from a few months of age to the early teens. Babies with cleft palates can be provided with a special appliance to aid feeding and bone shaping. Crossed bites in the primary dentition can be changed, extreme anterior spaces can be controlled, and space needs can be monitored. Bite plates, Frankel and Bionator appliances can achieve remarkable changes during the mixed dentition. Early evaluation of abnormal conditions is most important.

Today many adults have orthodontic treatment that they could not have received when they were twelve or thirteen because of financial reasons, but still desire the improvement that could be made. Adult orthodontics is just as successful as orthodontics for younger people. Generally speaking, the adult is slower in initial response but not necessarily longer total treatment time. Orthodontics can be done for adults at any age. As the person gets older there is probably more reluctance to start. Many patients, even up to fifty years of age, have started full orthodontic treatment.

Certain surgical procedures are used in conjunction with orthodontic treatment. The most obvious is the extraction of teeth to make the necessary space to facilitate the treatment. Labial frenectomy, surgical removal of tissue that interferes with spaced front teeth, is some- times done to help keep the space closed. Surgery is used to expose impacted teeth that are planned to be moved into position. Supracrestal fiber surgery, which snips stretched fibers, is used to aid in minimizing the relapse of badly rotated teeth.

Oral surgery and orthodontics may be used in a coordinated team approach to effect facial improvements. Some patients have extreme skeletal growth or lack of growth and require the reduction in length or increase in length of either jaws to improve facial balance.

The repositioning of the skeletal structure of the face is called orthognathic surgical procedures. There are basically three phases to this type of treatment: 1st phase is the orthodontic repositioning of the teeth in anticipation of orthographic surgery; 2nd phase is the oral surgical procedures and skeletal positioning; 3rd phase is the follow up orthodontic treatment and control of the bite.