1) When should I take my child to see an orthodontist?
That’s a great question, and there are, unfortunately, a lot of misconceptions about this issue. The American Association of Orthodontists, our specialty’s national organization, recommends that all children have an evaluation by an orthodontist no later than age 7.
2) Seven seems so young—what exactly is the orthodontist looking for at this first exam?
Mostly we’re looking for normal, age-appropriate development of the teeth and jaws. We want to make sure that your child has the correct number of adult and baby teeth for his or her age, as well as detect any problems that might be present so that, if needed, the appropriate treatment could be recommended.
3) Shouldn’t I wait until my child has lost all of his/her baby teeth before seeing an orthodontist?
Absolutely not! That’s a common belief among many parents, but it’s actually much better to have your child evaluated before all the baby teeth are lost. In some cases, starting orthodontics before all of the baby teeth are lost can be a critical part of the treatment and can often help avoid more complicated treatments down the road—in some cases it can even help avoid the need to remove permanent (adult) teeth.
4) Why do I see some children with braces on when they are only 7 or 8 years old? Isn’t that too young, and don’t they still have a lot of baby teeth left at that age?
When you see a child that young with orthodontic appliances on the teeth, that child is going through what is called a “Phase I” or “Interceptive Phase” of orthodontics. Most kids don’t need treatment at that age, but some do. Interceptive treatments can give the orthodontist the chance to guide jaw growth, correct harmful oral habits, lower the risk of trauma to protruding front teeth, guide adult teeth into a more favorable position, or even just improve appearance. Treating a child that young is the exception, not the rule, and should only be recommended in certain select situations.
5) If my child has orthodontic treatment at such a young age, will he or she still need braces again once all of the permanent teeth come in?
The goal of an early “Interceptive Phase” of treatment is usually to address a particular problem quickly and give the child every chance for the adult teeth to come in as normally as possible. This can address more serious problems from developing and may make treatment at a later age shorter or less complicated. So, although having early treatment won’t necessarily prevent the need for treatment at an older age, it can provide tremendous benefit and possibly simplify or shorten future treatments. In some cases, having early treatment can put the child in a position where future treatment is optional rather than absolutely necessary.
6) My 8-year-old has a healthy, good-fitting bite, but the adult front teeth that have come in are crowded together and don’t look nice. Can we have these teeth straightened if we want to?
Certainly. Many children with otherwise normal dental development come to the orthodontist at a young age because they just don’t like how their teeth look, especially in cases where the appearance of the teeth is causing the child to get teased at school. Straightening front teeth that are crowded together or spaced apart is a perfectly acceptable reason to have an early orthodontic treatment because it can have such a positive impact on a child’s self-esteem. That is also a very personal decision—some younger kids with crooked front teeth don’t mind it at all, while others may be very self-conscious about it.
We treated a really cute little girl, Morgan, whose mom brought her in because her front teeth were very rotated and crowded. Morgan was embarrassed about how her teeth looked, and some kids at school had started poking fun at her about it. We told her mom that her appearance was totally normal for her age and that orthodontic treatment wasn’t necessary unless they just wanted to do it to help Morgan feel better, and that’s exactly what they chose to do. Just a few months later, Morgan had completed her treatment, had beautiful straight front teeth, and had a totally different attitude about her smile. Both she and her mom were thrilled, and it was great to see her smile with no more embarrassment.
7) My child had beautiful, perfectly straight baby teeth, but now the adult teeth are coming in very crowded. What happened?
When a child loses their front six baby teeth, the adult teeth that replace them are much larger—sometimes almost twice as wide as they baby teeth they replace. So, if a child has “perfect” baby teeth with no spaces in between them, the adult teeth are almost guaranteed to be crowded when they come in. That’s why orthodontists love to see little kids with nice spaces in between all their front baby teeth, because that gives the permanent teeth the room that they need to come in straight.
8) So what is a good general rule about younger kids and the orthodontist?
Have your child evaluated early, at age 7 if possible. If your child is older than 7, don’t worry—it’s certainly not too late for a checkup. Also, don’t be afraid that just because you go to the orthodontist early you’re going to be told that your child needs braces. Most kids don’t need any orthodontic treatment that young, but on the slight chance that your child does have one of the conditions that needs early treatment, you’ll be doing your child a huge benefit by having them evaluated and treated now rather than later.
Parents are frequently surprised and relieved when we tell them that their child looks perfectly normal for their age and that no treatment is needed right now. They get to leave their appointment not only with peace of mind but also with a much better understanding of where their child’s dental development is now and what to expect in the future.