When should I bring my child in for their first appointment, and when should he/she start treatment?

When should I bring my child in for their first appointment, and when should he/she start treatment?
August 24, 2021

Today I am going to address a commonly asked question that I’ve touched on before in a Trivia Tuesday video- When should I bring my child in for their first orthodontic appointment? The American Association of Orthodontics recommends the first appointment occur at the age of 7. This is because there are a lot of concerns with tooth positioning, crowding, and the bite that start to come to light at this time. Although we rarely start treatment this young, I will be able to give you an idea of which teeth are forming, whether it looks like there will be enough room for the teeth, and whether we may need help with some bite correction in the future. If your child has a narrow top jaw, excessive crowding, crossbites, or other issues, we may discuss the pros and cons of doing an early round of braces (called a Phase I) before all of the permanent teeth come in. 

That being said, most kids are ready to start orthodontic treatment once all of their adult teeth come in. However, we like to see your child every 6 months-1 year for several years preceding that because some situations warrant braces or Invisalign a little sooner. There are a lot of reasons why some of the adult teeth may not erupt on their own without help from orthodontics. 

  1. They can be delayed if there is too much crowding and there isn’t a spot for them to grow, leading to an impacted tooth. 
  2. Sometimes the baby tooth may be “ankylosed,” or fused to the bone, in which case it would not fall out on its own without a dentist extracting it. 
  3. Yet another reason the adult teeth might not come in when expected is because dental age doesn’t necessarily correlate with chronological age. In other words, just because your child is 12 and the top canines usually erupt at 12 doesn’t mean that will happen. Some people’s teeth just take a little bit longer to develop. This is often the case if your child didn’t lose their baby teeth until he was a little older. For comparison, I didn’t get all my permanent teeth until I was almost 15.

In some situations, even if all of the baby teeth haven’t been lost, we may start orthodontic treatment anyway if we have bite correction that needs to occur. This is because some orthodontic goals are most easily and effectively achieved when the patient is still growing. For example, if a child has a crossbite, we can use an expander to fix it. However, a simple expander is only effective if the suture in the center of the top jaw hasn’t fused yet, which happens around puberty. Similarly, if a patient has a lot of overjet (or overbite, in layperson’s terms), we can modify the growth of the lower jaw to help fix the bite during the pubertal growth spurt. Once that growth has been completed though, the overjet becomes much harder to fix. 

To summarize, because teeth and the growth of the jaws is such a complex and ever-changing process, we recommend coming to see us when your child is around 7 years old! We typically won’t start treatment then, but I will explain what I will be watching for in the coming years and let you know when the best time to start the braces/Invisalign journey will be! As always, if you ever have any questions, feel free to give us a call/text at 704-782-5146, email us at office@bestorthonc.com, or send us a message @bestorthonc on Instagram.


Dr. Best

PS that photo is me 😛 at age 7. I had an early round of braces because I was being teased at school.