Abstract
Orthodontic treatment of children and adolescents must take into account their specific immature periodontal status. The decision to treat a situation entailing a periodontal risk has thus to be thought out more thoroughly than with adult patients.The basic problem lies in finding a proper balance between early treatment, which avoids any possible worsening linked to a risk-related situation, and monitoring, which avoids over-correction, at the risk of seeing the situation deteriorate during orthodontic treatment. A thorough orthodontic and periodontal examination will help identify the gingival biotypes and orthodontic movements liable to endanger the patient's periodontal health. The aim is to ensure that a specific periodontal treatment plan can be designed for each young patient and to enable a rapid response in the event of any occurrence or deterioration of a periodontal defect. The authors make several suggestions in order to get closer to the true situation and take the right decision regarding the difficult choice between interception and monitoring. Very regular follow-ups will be needed more often than with adults. Frequent appointments will enable the clinician to follow the progress of the periodontium, as well as the young patient's maturation process, making it possible to intervene quickly if recession occurs or worsens.
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