Early orthodontic treatment practices and perceptions: A cross-sectional survey of AAO members

To explore early treatment practices and perceptions among members of the American Association of Orthodontists (AAO).

Cross-sectional survey.

Members of the AAO.

An electronic questionnaire was pre-piloted and circulated via email to members of the AAO. The survey questions covered respondent demographics, clinical experience, preferred timing of intervention, treatment approaches and clinicians' perceptions with regard to early interceptive treatment. Descriptive statistics were performed.

A total of 228 responses were obtained (response rate = 5.12%). Treatment was commonly timed using dental age (61%) and pubertal signs (61.8%). Several problems were treated in the mid-mixed dentition phase (8-9 years) including posterior crossbite (51.3%) increased overjet (41.7%), crowding (39.5%), space loss (41.23%) and anterior open bite (37.3%). Commonly reported treatment approaches included the use of sectional fixed appliances for treatment of anterior crossbite (81.6%), rapid palatal expander for treatment of posterior crossbite (63.6%) and anterior bite plane for deep overbite correction (62.7%). Herbst appliance (42.1%) and facemask (89%) were commonly prescribed for early correction of Class II and III, respectively. Lingual and palatal arches were commonly used to preserve arch length. The majority of respondents (60.1%) were proponents of two-phase orthodontic treatment.

Early orthodontic treatment in the mid-mixed dentition stage was widely advocated for orthodontic intervention. Various malocclusions, including posterior and anterior crossbite, increased overjet, crowding, space loss and anterior open bite, were reported to be commonly addressed during this phase. Popular treatment approaches included sectional fixed appliances, Herbst appliance, facemask, rapid palatal expanders and anterior bite planes.