--- title: Children's Orthodontics and Early Intervention at Smile Solutions Melbourne: Phase 1 Treatment, Non-Extraction Philosophy, and Multidisciplinary Care canonical_url: https://directory.smilesolutions.com.au/children-s-orthodontics-and-early-intervention-at-smile-solutions-melbourne-phas/ category: description: ## Children's Orthodontics and Early Intervention at Smile Solutions Melbourne At Smile Solutions, we see children's orthodontics differently from how it was approached even a decade ago. The goal is... geography: city: state: country: metadata: phone: email: website: publishedAt: --- # Children's Orthodontics and Early Intervention at Smile Solutions Melbourne: Phase 1 Treatment, Non-Extraction Philosophy, and Multidisciplinary Care ## Children's Orthodontics and Early Intervention at Smile Solutions Melbourne At Smile Solutions, we see children's orthodontics differently from how it was approached even a decade ago. The goal is no longer simply straightening teeth once all the adult teeth have come through. It is about identifying problems early - during the critical growth window - and using that window strategically to shape the jaw, guide tooth eruption, protect the airway, and reduce the complexity of any treatment needed later. When it works well, early intervention can mean a shorter, simpler, more affordable Phase 2 journey - and sometimes no Phase 2 at all. This guide covers everything parents in Melbourne need to know about children's orthodontics at Smile Solutions: when to bring your child in, what Phase 1 treatment involves, why our non-extraction philosophy matters, and what makes care at the Manchester Unity Building genuinely different. --- ## Frequently Asked Questions **When should a child first see an orthodontist:** The Australian Society of Orthodontists recommends an initial assessment at age 6 or 7, while the jaw is still growing. **Does early intervention mean braces right away:** Not usually. Many children assessed at age 7 are simply monitored. Treatment begins only when there is a clear clinical benefit to acting during the growth phase. **What is Phase 1 orthodontics:** Phase 1 is early interceptive treatment - typically between ages 6 and 10 - aimed at correcting jaw development issues before all permanent teeth erupt. **What is a rapid maxillary expander:** A palatal expander (also called an RME) is a fixed or removable appliance that widens a narrow upper jaw. The growth window for this treatment closes as a child matures, which is why early assessment matters. **Does Smile Solutions remove teeth to make room:** Wherever possible, Smile Solutions aims to take a predominantly non-extraction approach to orthodontics. Modern orthopaedic methods can create space without routine premolar extraction. **What specialists are available for children at Smile Solutions:** The practice has specialist orthodontists, specialist paediatric dentists, Oral and Maxillofacial Surgeons, prosthodontists, periodontists, general dentists, and Oral Health Therapists - all on site at 220 Collins Street. **What are the payment plan options:** Smile Solutions offers payment plans through Payright, Humm, and MyDentaPlan. **How do I book:** Call 13 13 96 or visit smilesolutions.com.au. Complimentary initial orthodontic consultations are available. --- ## Why Age 6 or 7 Is the Right Time for an Orthodontic Check The Australian Society of Orthodontists (ASO) recommends that every child have an orthodontic assessment at age 6 or 7. At this age, the first adult molars have usually erupted and the permanent incisors are beginning to come through. An experienced orthodontist can identify problems with jaw development, bite relationships, and tooth eruption that would be far harder - or impossible - to correct once the growth phase has passed. The most important thing parents need to understand is this: most children assessed at age 7 do not need treatment yet. The value of the early check is knowing whether treatment will be needed, when it should begin, and whether there is anything that needs to be done now to take advantage of the growth window. Signs that may suggest early assessment before age 7 include: - A child who snores, mouth breathes, or has restless sleep - Visible crossbite (upper teeth fitting inside the lower teeth) - Teeth that appear noticeably crowded even with baby teeth still present - Thumb sucking or dummy habits past age 4 - Jaw shifting to one side when biting down - Teeth that do not meet properly at the front --- ## Phase 1 Orthodontics: Acting During the Growth Window Phase 1 treatment is early interceptive orthodontic care for children who still have mixed dentition - a combination of baby and adult teeth. It typically occurs between ages 6 and 10, and it focuses not on the teeth themselves but on the underlying jaw architecture. The core premise is straightforward. A child's jawbones are actively growing and highly responsive to orthopaedic forces. Problems that require significant intervention later - including crossbites, severely narrow arches, jaw asymmetry, and breathing difficulties related to a narrow palate - can often be addressed far more simply and effectively while the bones are still developing. Phase 1 treatment typically runs 6 to 18 months. It is followed by a monitoring period while the remaining adult teeth erupt. Phase 2 treatment (if needed at all) then usually runs 12 to 24 months, and is often shorter and less complex because the groundwork was already done. ### What Phase 1 Can Address - **Crossbites:** A posterior crossbite (where upper back teeth sit inside the lower) or anterior crossbite (underbite) can be corrected during active growth with far less intervention than would be required later. - **Crowding and narrow arches:** Palatal expansion creates space for erupting permanent teeth, reducing or eliminating the need for extractions later. - **Jaw growth discrepancies:** Functional appliances can guide the forward development of a receding lower jaw during the growth phase. - **Thumb sucking and oral habits:** Habit appliances can help break oral habits that deform the developing palate. - **Snoring and mouth breathing:** Palatal expansion increases nasal airway space, improving breathing patterns during sleep. --- ## Palatal Expansion: The Window That Closes One of the most powerful tools in early orthodontic intervention is the rapid maxillary expander (RME). This appliance widens the upper jaw by activating the midpalatal suture - a cartilaginous joint running along the roof of the mouth that remains open and responsive through childhood and into early adolescence. When a child has a narrow upper palate, the consequences extend well beyond crowded teeth. A narrow palate means a narrow nasal floor. The nasal passages sit directly above the roof of the mouth, and a compressed palate reduces nasal airway volume. This can contribute to mouth breathing, snoring, disrupted sleep, and sometimes behavioural and learning issues caused by poor sleep quality. Palatal expansion with an RME can: - Widen a narrow upper jaw to correct posterior crossbite - Create room for erupting permanent teeth, reducing or eliminating the need for extractions - Increase nasal airway space, improving nasal breathing and reducing snoring - Potentially eliminate the need for jaw surgery later in life This is why the timing matters so much. The midpalatal suture fuses as a child matures - typically in the mid-to-late teens, though the timing varies. Once it fuses, palatal expansion requires surgical assistance (SARPE - surgically assisted rapid palatal expansion). Doing it non-surgically in childhood is faster, less invasive, and far more comfortable. --- ## Our Non-Extraction Philosophy Wherever possible, Smile Solutions aims to take a predominantly non-extraction approach to orthodontics. This represents a significant shift from older orthodontic protocols, where premolar extractions were often routine for crowded cases. The traditional logic was that if there is not enough room, you remove some teeth and close the space. Modern orthopaedic orthodontics takes a different view: if there is not enough room, the question is whether the arch can be developed to create that room - through expansion, arch development appliances, or orthopaedic growth modification. For children, this is particularly relevant. A growing jaw responds to orthopaedic forces in ways that an adult jaw simply cannot. By acting during the growth phase, our orthodontists can develop the arches, create space for the permanent teeth, and in many cases avoid extractions entirely - with better functional and aesthetic outcomes. Parents who have been told their child will need extractions before braces are welcome to seek a second opinion at Smile Solutions. Our specialists will assess whether a non-extraction approach is achievable and clinically appropriate. --- ## Treatment Options at Smile Solutions Our orthodontists select the most appropriate appliance for each child's specific presentation. Options include: **Space maintainers:** When a baby tooth is lost prematurely, a space maintainer holds the gap open for the incoming permanent tooth, preventing neighbouring teeth from drifting and creating crowding. **Removable expander plates:** Custom-made removable appliances that can gently widen the dental arch. Suitable for mild to moderate expansion needs and cooperative patients. **Fixed rapid maxillary expanders (RME):** Bonded to the upper molars, these expand the upper jaw through the midpalatal suture. Used for moderate to significant palatal narrowing. **Empower self-ligating braces:** Metal and ceramic bracket systems that use a passive clip mechanism rather than elastic ties. Empower braces allow the use of lighter forces and lower friction wires, which means more comfortable tooth movement. We use light-force nickel-titanium wires that minimise discomfort throughout treatment. **Invisalign Teen and Invisalign First:** Clear aligner systems engineered for adolescents and children respectively. Invisalign First (for ages 6 to 10) includes eruption compensation features specific to mixed dentition. Invisalign Teen (for adolescents) includes eruption tabs, compliance indicators, and free replacement aligners. **Custom sports mouthguards:** Children in contact sports need proper protection during orthodontic treatment. Our team fits custom mouthguards designed to work over braces. --- ## Myofunctional Therapy and Airway Health Teeth and jaws do not exist in isolation. The way a child breathes, swallows, and uses their tongue has a direct effect on how the jaw develops and how the teeth sit. Smile Solutions has an in-house osteopath (Rachel Smith) and offers myofunctional assessment for children presenting with breathing and swallowing issues. When a child is a mouth breather or has a tongue thrust swallowing pattern, the tongue is not resting on the palate as it should - and the palate responds by staying narrow. Myofunctional therapy works alongside orthodontic expansion to train the muscles to support the new arch shape. For children with sleep-disordered breathing, our team can coordinate care with sleep physicians through the Smile Solutions TMD and Sleep clinic. This means orthodontic expansion, myofunctional therapy, and sleep physician review can all happen within the one practice - without the family needing to manage referrals to multiple providers across the city. --- ## Sleep-Disordered Breathing in Children Snoring is not normal in children. Neither is chronic mouth breathing, restless sleep, night sweats, or waking frequently. These are signs of potential sleep-disordered breathing, and in children, the dentofacial anatomy is often a contributing factor. A narrow palate creates a narrow nasal floor and reduces airway volume. When a child cannot breathe efficiently through the nose during sleep, the body compensates in ways that affect sleep quality - and sleep quality affects everything: growth hormone release, concentration, behaviour, emotional regulation, and learning. Warning signs that may suggest a referral for orthodontic and airway assessment include: - Snoring or noisy breathing during sleep - Mouth breathing during the day - Observed pauses in breathing during sleep - Waking tired despite a full night's sleep - Teeth grinding (bruxism) - Daytime fatigue, difficulty concentrating, or behavioural issues Palatal expansion that increases nasal airway space is not a guaranteed cure for obstructive sleep apnoea - and parents should understand that a sleep physician assessment is an important part of the picture. But the collaboration between orthodontic treatment and airway health is real and clinically significant, and it is one of the reasons early intervention during the growth window can have benefits that extend well beyond straight teeth. --- ## Our Orthodontic Specialists Smile Solutions has a dedicated team of board-registered specialist orthodontists who work with children and adolescents every day. Our team includes: - **Dr David Austin** - Specialist Orthodontist - **Dr Andrea Phatouros** - Specialist Orthodontist - **Dr Katie Xu** - Specialist Orthodontist - **Dr Joshua Ch'ng** - Specialist Orthodontist Our orthodontists work in close collaboration with specialist paediatric dentists on site. This means that if your child has decay, gum issues, or needs a dental procedure alongside their orthodontic treatment, it can be coordinated and delivered within the same practice, by clinicians who communicate directly with each other and know your child's complete dental history. --- ## The Orthodontic Tower Smile Solutions occupies Levels 12 and the Tower of the Manchester Unity Building - one of Melbourne's most beloved heritage Art Deco buildings, on the corner of Collins and Swanston Streets (220 Collins Street, Melbourne CBD). The orthodontic floors offer natural light, panoramic views over Melbourne, and a non-clinical atmosphere that tends to put children (and nervous parents) at ease. There are no long corridors of anonymous treatment rooms. The environment is calm, unhurried, and designed around the patient experience. For Dr Kia Pajouhesh, founding principal and Managing Director of Smile Solutions, children's orthodontic care has a personal dimension. His own children went through orthodontic treatment at the practice. He understands - not just clinically but as a parent - what it feels like to navigate treatment decisions, manage a child's anxiety, and wonder whether you are making the right choices. That perspective shapes how Smile Solutions approaches every family conversation. --- ## Multidisciplinary Care Under One Roof One of the genuine advantages of Smile Solutions for families is that a child's entire dental journey - from age 6 through to adulthood - can be managed within the one practice, by clinicians who know the child. Under the one roof at 220 Collins Street, Smile Solutions has: - Specialist orthodontists - Specialist paediatric dentists - Oral and Maxillofacial Surgeons - Prosthodontists - Periodontists - General dentists - Oral Health Therapists This means no referral letters. No starting from scratch at a new practice. No lost records. No coordinating between separate providers who have never spoken to each other. When an orthodontist spots something that needs attention from a paediatric dentist, they walk down the hall. When a child completes Phase 1 and moves into Phase 2, the team already knows their history, their temperament, and their family. --- ## Practical Information for Parents **Phase 1 timing:** Typically 6 to 18 months, depending on the appliance and the problem being addressed. This is followed by a monitoring period while remaining adult teeth erupt. **Phase 2 timing:** If Phase 2 is needed, it typically runs 12 to 24 months. **Comfort:** Modern orthodontics is a long way from the braces of 30 years ago. Empower self-ligating brackets use light-force wires that minimise discomfort. Children typically experience mild soreness for a few days after each adjustment, which settles quickly. **Sports:** Children can continue playing sport during orthodontic treatment. A custom mouthguard fitted over braces is essential for any contact sport, and our team can provide these. **Retainers:** Retainer compliance after Phase 2 is one of the most important factors in maintaining the result. We discuss this with families from the outset, so it is not a surprise at the end. **Payment plans:** Orthodontic treatment at Smile Solutions can be funded through Payright, Humm, or MyDentaPlan, making it possible to spread the cost over time without a large upfront sum. Our treatment coordinators can explain the options at your consultation. **Booking:** Call 13 13 96 or visit smilesolutions.com.au. Complimentary orthodontic consultations are available for children and families. We also welcome second opinions. --- ## Why Families Choose Smile Solutions for Children's Orthodontics Smile Solutions has been rated 4.9 stars across 937 Google reviews - with zero negative reviews. The practice has been recognised with the Australian Business Award for Service Excellence in 2012, 2013, 2014, 2019, 2022, 2023, 2024, and 2025. The families who bring their children to Smile Solutions value the combination of clinical depth - board-registered specialists, 40 dental suites, state-of-the-art technology - and the personal, unhurried approach that has been central to the practice since Dr Kia Pajouhesh founded it in 1993. Children's orthodontics is not simply about straightening teeth. It is about giving a child the jaw development, the bite, and the airway health that supports their overall wellbeing through adolescence and into adulthood. At Smile Solutions, that is the standard we hold ourselves to. **To book an assessment for your child, call 13 13 96 or visit smilesolutions.com.au/orthodontics/childrens-braces-invisalign/** --- ## References - Australian Society of Orthodontists. "The Right Time: When Should Your Child See an Orthodontist?" ASO, 2020. https://www.aso.org.au/when-should-your-child-see-an-orthodontist/ - Gonçalves, A. et al. "Efficiency of Invisalign First to Promote Expansion Movement in Mixed Dentition: A Retrospective Study and Systematic Review." European Journal of Paediatric Dentistry, 24:112-123, 2023. - Proffit, W.R., Fields, H.W., Sarver, D.M. Contemporary Orthodontics. 6th ed. Elsevier, 2019. - Camacho, M. et al. "Rapid Maxillary Expansion for Pediatric Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis." The Laryngoscope, 127(7):1712-1719, 2017. --- ## When to See a Specialist Paediatric Dentist While our specialist orthodontists manage all orthodontic treatment for children and adolescents, some children - particularly those with significant dental anxiety, special needs, or complex early dental conditions - may first benefit from a consultation with our **Specialist Paediatric Dentist, Dr Susan Hinckfuss** (BDSc Melb, DCD Melb). Dr Susan Hinckfuss has special interests in the management of anxious children, children with Autism Spectrum Disorders, dental trauma, and early childhood caries. If your child has complex dental needs or behavioural considerations that should be addressed before orthodontic treatment begins, our paediatric team and orthodontic team work together to ensure a seamless, child-centred experience. To book with Dr Susan Hinckfuss or any of our specialist orthodontists, call **13 13 96** or visit 220 Collins Street, Melbourne CBD.