Having a child with an overjet (colloquially overbite) malocclusion can a be stressful and confusing experience. It doesn’t help that many doctors disagree about the best treatment practices to correct this bite discrepancy.

1. Early Skeletal Correction- Phase 1 Functional Appliance Correction before skeletal maturity (usually ages 6-9)
2. Late Dentoalveolar Correction- Use rubber bands at the same time as braces (ages 11-14)

Research actually supports both philosophies, but the aesthetic outcome may differ.

Early Skeletal Correction:

Early correction and actual skeletal change through the growth of the lower jaw can be obtained easily with removable, functional appliances. Two of the most popular appliances are the Twin Block™ and the Bionator.™ Headgear is another common way to correct overjet, but StraightSmile Solutions® doesn’t support traditional headgear for bite correction because it moves the upper teeth backward instead of forward, which may affect the tongue space or airway volume. More research is still needed to understand all of the possible effects. My professional experience does indicate that children who have early, successful Class II correction are less likely to need premolar extractions and orthognathic surgery as an adult.
The Twin Block™ is a comfortable appliance that can be customized and “blinged-out” to make wearing it more fun for a young child. It looks very much like two retainers. The Bionator™ is a one-piece appliance that may be more challenging to wear at school, but it does have the favorable side effect of helping to correct mouth breathing and oral habits, which may also improve facial aesthetics in the long term.

Early treatment often comes with an additional price tag. Many orthodontists charge twice for this set of orthodontic treatments, which pushes the fees to around $6000-$10000 for the whole correction. Timing and compliance (full-time wear) are the key. For the best outcome, these need to be worn up until the peak growth spurt. This can be as early as age 8 in a female and as late as age 15 in a male. Parents often don’t understand the importance of timing with these appliances.


Late Dentoalveolar Correction:

The advantage of Class II elastic treatment to correct an overjet is that it usually costs less overall. It can be accomplished with either clear aligners or traditional braces. With clear aligners, intraoral elastics may be worn from the very start, with the first align¬er, which may be a quicker correction. In contrast, with braces you have to wait until about halfway through the braces treatment to initiate the elastics so that the wire is heavy enough to support the forces.

Class II elastics are a common treatment modality to correct a Class II dental malocclusion, and their effects are primarily dentoalveolar. That means that bone isn’t growing; the teeth are just tipping to fix the bite. This could be considered a less stable outcome in the long term, and it won’t provide the patient with the accompanying improvement in profile aesthetics.

For support with your orthodontic cases, please visit www.straightsmilesolutions.com.