Two treatment timings, more than one question
Cochrane's 2018 review examined prominent upper front teeth in children and adolescents. It compared early treatment in two phases with one course in adolescence, and separately examined adolescent treatment versus no treatment and different appliances. Those are separate comparisons.
The review describes early study treatment at ages seven to eleven and later treatment at around twelve to sixteen. These describe the research groups, not a rule for choosing treatment or a deadline for a child. The family's recommendation requires its own assessed purpose.
Publication was 13 March 2018; the evidence search ended on 27 September 2017. This guide uses the official plain-language summary and structured abstract, not the inaccessible full review or individual trial reports.
Keep the timepoint beside the outcome
| Question or timepoint | What the reported finding means |
|---|---|
| After the early phase | Early functional-appliance treatment reduced prominence at a point when the later group had not yet received its intervention. That is an earlier checkpoint, not the final comparison after both groups finished. |
| After both groups completed treatment: Final forward projection | The compared early and later groups had no detected difference in final overjet. Confidence was limited; this is not proof of identical results for every person or every outcome. |
| Injury incidence | Early treatment reduced new upper-incisor injuries compared with later care in the studies, with low to moderate confidence. This population finding does not predict a particular child's injury or guarantee prevention. |
The positive injury finding concerns how often an event occurred in the compared groups. The final-overjet finding concerns the forward relationship after treatment. One does not cancel or replace the other, and neither sentence supplies the decision for an individual family.
Adolescent treatment versus no treatment is another comparison
Low-quality evidence in the review supports functional-appliance treatment in adolescence reducing upper-front-tooth prominence versus no treatment. That is not the same question as early versus later care. Do not combine the comparisons to conclude that a particular child should start early or wait.
The studied category also does not establish a device offered at SMILE-FX®, personal suitability or a wear arrangement. A real proposal connects the assessed finding with its intended change and individual responsibilities.
What a family can take from this
The useful completed reading is that an earlier change, final projection and injury incidence are different questions. The review supports a dated discussion of purpose and timing; it does not establish superior final alignment, a personal injury forecast or that later care will be avoided.
Most comparisons had low-quality evidence. A 2025 conference update was discovered, but its body was unavailable and contributes no findings here. This is not a claim to the latest complete evidence. The family proposal lesson shows how to keep a supplied clinical goal and the remaining personal decision separate.
Sources for this lesson
Sources: Cochrane: Prominent upper front teeth (2018 summary/abstract)