When to Start Orthodontic Treatment?

Even though for most cases it is ‘the sooner – the better’ , that is not a general rule for all patients. The best age to start wearing braces will vary from patient to patient, but it is very important that an initial orthodontic evaluation is done early enough, immediately after a possible problem is noticed.

The American Association of Orthodontist (AAO) recommends that all children have a check-up with an orthodontist by the 7th year of age, for early detection of any potential problems. The child’s teeth may appear straight to the eyes of the parents, but there could still be a problem that only an orthodontist can detect.

By the age 7, some of the permanent teeth have erupted, so that most children have a mix of adult and baby teeth. At this stage of mixed dentition, an orthodontist can spot potential orthodontic problems related to jaw growth and eruption of adult teeth. Some growth-related orthodontic problems are easier to correct when they are identified early, while the facial bones are still growing.

When a problem is detected, the orthodontist may not always recommend immediate treatment. In most of the cases parents are advised to bring the child every 6 months for periodic monitoring of the jaw growth and dental development.

Although only a few orthodontic problems need to be corrected at the age of 7, it is considered as an ideal time to evaluate a child’s condition and determine if orthodontic treatment is or will be needed. In case of existing or potential malocclusion problems, an early orthodontic screening allows the orthodontist to offer advice and guidance for the best age to start treatment and what kind of treatment will be appropriate.

Learn more on how to find an orthodontist

In the past, orthodontic treatment was common only during adolescent or teenage years, when all the permanent teeth had erupted. Until some years ago, it was unusual to start orthodontic treatment at the age of 7 or after 20’s. But today the situation is different; you can meet patients of a wide range of ages in an orthodontist’s waiting room. Orthodontic treatment can start in:

• Early childhood - certain conditions, such as crowding, may be easier to address by starting an orthodontic treatment from the age of 7. Early treatment allows to take advantage of the jaw bones growth process to guide teeth to their correct position.
• Adolescent and teenage years – if there are no problems that require an early intervention, orthodontic treatment is most effective at this age when all the permanent teeth have erupted and most of the jaw development has completed.
• Adulthood - adult orthodontics offer the opportunity of a better smile to all those that couldn’t get orthodontic treatment in their teenage years. Treatment in adults generally takes more time and might require corrective jaw surgery because the jaw bones are already fully developed.

In order to determine the best time to start the treatment of malocclusion problems, the orthodontists evaluates a number of factors such as:

• when it will be most effective to achieve the movement of misaligned teeth,
• when the minimum time will be required and
• how to minimize the cost of orthodontic treatment for the patient.

Early orthodontic evaluation gives the opportunity to the orthodontist to design a treatment plan to correct the teeth misalignment in a time and cost efficient way. An early orthodontic treatment (also known as Phase I or interceptive treatment) can take into advantage the growing process of the facial bones.

The usual goal for an orthodontist to start a child’s treatment at an early age is to guide the growth of jaw bones and create the optimum environment for the eruption of permanent teeth. This may prevent the development of more serious problems in the future and may make treatment at a later age shorter and less complicated.

For example, a teeth crowding problem may occur when the dental arch is too small to fit all of the teeth. For a teenager where the jaw bones were almost fully grown, the only solution for crowding was almost always to extract some of the permanent teeth. This can be prevented by starting the orthodontic treatment in earlier age and using expansion devices to modify the width of the palate, which can help teeth come in straighter and into better positions.

Interceptive orthodontic treatment may also be useful when the dental arches and jaws are not in the correct position. Certain types of functional (growth) appliances may fix or improve these problems. Treatment may also include the use of space maintainers after a baby tooth is lost to hold the space open for the permanent tooth. Dental braces may be still needed later but the required treatment will be shorter and simpler.

Early treatment does not apply to all orthodontic problems. However, it may help in several cases to:

• Guide jaw growth into favorable direction and size
• Prevent more serious problems from developing
• Lower the risk of injury to protruded front teeth
• Reduce treatment time and complexity at later age
• Minimize the need of jaw surgery
• Minimize the need of permanent teeth extractions
• Correct harmful oral habits (i.e. thumb or finger sucking, tongue thrusting and mouth breathing)

The cost of orthodontic treatment can be significant and many patients may not afford it if they are not covered by their dental insurance. Learn how to choose a dental insurance plan that will provide the best dental treatment to you and your family.