Almost every orthodontic case has some component of function and some part of esthetics. Seeing an eight or nine year old with a severe protrusion certainly takes both into account. There are several reasons for evaluating this patient at 8 or 9 or 10.
Firstly, the protrusion may be a sign that the lower jaw is retrusive and under growing the upper jaw. This discrepancy will continue and it may be possible to assist in the development of the lower jaw using orthopedic appliances like a headgear or a Herbst. If the lower jaw falls behind the upper jaw too much it may be impossible to correct as well at an older age.
Secondly, upper teeth that are so far forward like this are at a severe risk of being physically traumatized. Without the protection of the lip the front teeth may be fractured by a baseball or soccer ball or simply horseplay at school.
Lastly there is the more personal issue of self-esteem and peer pressure or ridicule. A child can become extremely self-conscious of their smile and become emotionally affected by protrusive teeth.
If one or more of these reasons are present it may be advantageous to place orthodontic appliances for a short time to begin the correction. Sometimes the young patient may out grow the protrusion. Evaluating the growth and development, the orthodontist can help you make a decision whether to treat or wait.
