The First Orthodontic Exam

One of the most common questions we get asked by moms is “When should I bring my child in to see you for the first time?” It’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.

This response is usually met by a confused/mortified look on mom’s face, as she’s thinking, “No way. That’s WAY too early.” But it’s really not, because as orthodontists, we can gain a ton of information about a child’s orthodontic condition simply by taking some pictures of the teeth, taking a simple x-ray, and doing a brief exam. When we examine younger children, we’re really just 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.

Many parents think that they’re supposed to wait until all of their child’s baby teeth have fallen out before visiting the orthodontist. That’s a common misconception, but it’s actually much better to have your child evaluated before all the baby teeth are lost. In some cases, having an evaluation before all of the baby teeth are lost can be a critical part of planning and can often help avoid more complicated treatments down the road.

Now, don’t get us wrong—we’re absolutely NOT implying that most 7 and 8-year-olds need to get braces or have some sort of orthodontic appliance. Most kids actually DON’T need treatment at that age. But a very small percentage do, and it’s those that we’re trying to detect. Early orthodontic treatments (sometimes called “Phase I” or “Interceptive” treatments), if needed, can give the orthodontist the chance to guide jaw growth, correct harmful oral habits, lower the risk of trauma to teeth, guide adult teeth into a more favorable position, or even just improve appearance. But make no mistake—treating a child that young is the exception, not the rule, and should only be recommended in certain select situations.

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.

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So, what’s a good general rule? Have your child evaluated by an orthodontist early, at age 7 if possible. If your child is older than 7, don’t worry—it’s certainly not too late for an evaluation, and a little late is better than a lot late. 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 orthodontic development is now and what to expect in the future.