Short answer: The American Association of Orthodontists (AAO) recommends that children have their first orthodontic checkup no later than age 7. At this age, baby teeth and permanent teeth are present in the mouth together (the mixed dentition); problems with jaw development and the bite can be spotted early. An early checkup does not mean treatment for everyone; most children are simply monitored. If a problem is noticed earlier, there is no need to wait until age 7.
According to the recommendation of the American Association of Orthodontists (AAO), a child's first orthodontic checkup should take place no later than age 7. The reason is that at this age both baby and permanent teeth are present in the mouth, and problems in jaw development can be noticed at an early stage. This checkup does not mean every child will start treatment. In most children, the eruption of the teeth and the growth of the jaws are simply monitored. However, for some problems, a small intervention at the right time can reduce the need for more extensive treatment later. In this article we explain why age 7 matters, what is checked during the examination and which signs mean you should come in sooner.
Why age 7?
At around 6–7 years of age, the first permanent molars and the permanent front teeth begin to erupt. This period, when baby and permanent teeth are present together in the mouth, is called the mixed dentition. The mixed dentition gives the orthodontist valuable information:
- How the first permanent molars fit together, which is the foundation of the back bite, can be seen.
- The direction in which the front teeth are erupting and whether there is a space problem can be assessed.
- An initial idea of the growth direction of the upper and lower jaws relative to each other can be formed.
- The presence and position of permanent teeth that have not yet erupted can be checked with an X-ray.
Because the jaws are still growing during this period, some problems can be guided more easily by taking advantage of growth. For broader information about suitable ages and treatment options for your child, see our article at what age can clear aligners be used.
What is checked at the first orthodontic examination?
The first examination is usually a short visit that is comfortable for the child. The orthodontist evaluates the following:
- Order and timing of tooth eruption: Are the baby teeth falling out on time, and are the permanent teeth coming in in the right place?
- Space: Is there enough room in the jaw for the permanent teeth to fit?
- Bite: How do the front and back teeth fit together; is there a crossbite, open bite or deep bite?
- Jaw relationship: Is the lower jaw set back or forward; does the jaw shift to one side when opening and closing the mouth?
- Habits: Is there thumb sucking, pacifier use, tongue thrusting or mouth breathing?
- X-rays: If considered necessary, a panoramic X-ray is used to check for missing, extra or impacted teeth.
By the end of the examination, the aim is usually to answer four questions: Is there a problem; if so, what options are there; if treatment is needed, when should it start; and how long might it take?
Which signs mean you should come in before age 7?
The AAO stresses that there is no need to wait until age 7 once a problem is noticed. If you see any of the following signs, you can plan an earlier examination:
- Baby teeth falling out very early or very late,
- Difficulty or pain when chewing or biting,
- Mouth breathing, snoring,
- The jaw shifting or making a clicking sound,
- Speech difficulty,
- Frequently biting the cheek or the roof of the mouth,
- Noticeable asymmetry in the face, lips or jaw,
- Teeth clenching or grinding.
Habits such as thumb sucking and prolonged pacifier use should also be watched carefully. If these habits continue into school age, they can contribute to an open bite in the front teeth and narrowing of the upper jaw. The AAO also reminds parents that teeth will not straighten on their own as the child grows.
Does an early checkup mean treatment for everyone?
No. This is one of the questions parents ask most often. A significant share of children examined around age 7 do not need immediate treatment. For these children, the orthodontist recommends monitoring tooth eruption and jaw growth at set intervals. Thanks to these monitoring visits, if a problem develops, it is spotted at the most suitable time.
When treatment is needed, it is usually considered in two phases. A short treatment carried out at an early stage is called phase 1 (first-phase) treatment. If needed, a second phase can be planned after most of the permanent teeth have erupted. Not every child needs both phases; the decision is made during the examination based on the child's situation.
What methods are used in early (phase 1) treatment?
The aim of phase 1 treatment is to use growth to keep a problem from getting worse or to create more favorable conditions for the permanent teeth. The main methods used are:
- Palatal expander: Widens a narrow upper jaw, helping to correct a crossbite and gain space for the teeth.
- Space maintainer: When a baby tooth is lost early, it prevents neighboring teeth from drifting into the gap and preserves the space for the permanent tooth.
- Functional appliances: In some jaw relationship problems, they can help guide growth.
- Invisalign First: A clear aligner system designed for children in the mixed dentition stage; in suitable cases it can be used for jaw expansion and tooth alignment. For details, see our Invisalign First for children page.
For more information about appliances, you can read our orthodontic appliances page.
What are the possible benefits of early diagnosis?
The purpose of an early checkup is to spot problems during the period when growth is most favorable. In suitable cases, a timely intervention can provide the following benefits:
- Widening a narrow upper jaw while the bones are still flexible,
- Creating space for the permanent teeth to erupt and reducing the need for tooth extractions later,
- Reducing the risk of protruding front teeth being damaged in falls and impacts,
- Correcting a crossbite that causes the jaw to shift to one side before asymmetry sets in,
- Addressing the effects of habits such as thumb sucking and tongue thrusting early.
These benefits do not apply to every child. For some problems, it is more appropriate to wait and start treatment after the permanent teeth have erupted. You can discuss how the timing is decided with your orthodontist during the examination.
How can you prepare for the checkup?
The first orthodontic checkup is usually an easy visit for children that involves no pain or needles. A little preparation helps make the visit more productive:
- Explain to your child in simple words that the visit is to count and look at their teeth.
- Note any habits you have noticed: thumb sucking, mouth breathing, snoring, teeth grinding.
- Try to remember when the baby teeth fell out and any previous dental treatments.
- Bring any dental X-rays taken before, if available.
- Mention if anyone in the family has jaw or bite problems; jaw structure can have inherited features.
What are the most common orthodontic problems in children?
Among the common problems listed by the AAO, the conditions frequently seen in children are:
Crowding
When there is not enough room for the teeth to fit, they overlap or come in rotated. If a space problem is noticed early, options such as expansion or a space maintainer can be considered. See crowded teeth.
Protruding teeth
Upper front teeth that sit noticeably forward can increase the risk of the teeth breaking in falls and impacts. The AAO notes that this problem is often easier to treat during childhood and adolescence, while growth is still ongoing.
Bite problems
- Open bite: When the back teeth close, the front teeth do not touch; this may be linked to thumb sucking and tongue thrusting. See open bite.
- Deep bite: The upper front teeth overlap the lower front teeth too much. See deep bite.
- Crossbite: Some upper teeth sit inside the lower teeth; the jaw may shift to one side. See crossbite.
- Lower jaw sitting forward: The lower front teeth close in front of the upper front teeth; early assessment is important.
Orthodontic checkups for children in Çankaya, Ankara
At Funda Sarıkaya Oral and Dental Health Polyclinic, children's orthodontic examinations are carried out by Funda Pekyılmaz Sarıkaya, specialist orthodontist (Uzm. Dt.). During the examination, your child's teeth, bite and habits are evaluated; X-rays are taken if considered necessary. You are then told whether treatment is needed and, if so, when it would be appropriate to start; in most cases, monitoring is planned. To book an appointment, you can reach us through our contact page.
Sources: This article has been prepared in our own words based on the American Association of Orthodontists' patient information on child orthodontics and common orthodontic problems.
Frequently asked questions
At what age should a child first see an orthodontist?
The American Association of Orthodontists recommends that the first orthodontic checkup take place no later than age 7. Because baby and permanent teeth are present together at this age, problems with the bite and jaw development can be noticed early. If a problem catches your attention earlier, you can schedule an examination without waiting until age 7.
Does every child examined at age 7 need treatment?
No. A significant share of children examined at this age do not need immediate treatment; tooth eruption and jaw growth are monitored at set intervals. Treatment is recommended only when early intervention will provide a benefit. Whether your child needs monitoring or treatment is decided during the examination, and you are informed of the monitoring intervals.
What is phase 1 orthodontic treatment?
Phase 1 is a short, early treatment carried out during the mixed dentition stage, taking advantage of growth. Methods such as a palatal expander, a space maintainer, functional appliances or, in suitable cases, Invisalign First may be used. The goal is to keep the problem from getting worse and to create suitable conditions for the permanent teeth. A second phase may be needed after the permanent teeth have erupted.
Does thumb sucking affect the teeth?
If thumb sucking and prolonged pacifier use continue into school age, they can contribute to an open bite in the front teeth, forward tipping of the front teeth and narrowing of the upper jaw. The extent of the effect depends on how often and how long the habit continues. If the habit persists, the teeth and jaws are evaluated during an orthodontic examination.
Will my child's teeth straighten on their own as they grow?
The American Association of Orthodontists states that teeth will not straighten on their own as a child grows. Some mild irregularities may change as the permanent teeth erupt, but space problems and bite problems usually do not resolve by themselves. That is why an early checkup and, if needed, monitoring are important for determining the most suitable timing if treatment is required.
