Short answer: A child's first orthodontic checkup is recommended at around age 7; by this age the first permanent molars and incisors have erupted and problems with jaw development can be detected. Crossbite, severe crowding, a lower or upper jaw that lags behind and harmful habits may require early intervention. Treatment can use orthodontic appliances, braces or clear aligners.
One of the questions parents frequently ask is when they should see an orthodontist about their child's teeth. Many families think it is right to wait until all the permanent teeth have come in; however, when it comes to orthodontics for children, some problems can be guided much more easily and effectively while the child is still growing. In this article we discuss, in language parents can understand, the timing of the first orthodontic checkup, the situations that call for early intervention and the treatment options used for children.
At what age should the first orthodontic checkup take place?
Many international organizations, led by the American Association of Orthodontists (AAO), recommend that children have their first orthodontic evaluation at around age 7. By this age, the first permanent molars and the front incisors have usually erupted. By looking at the position of these teeth, the orthodontist can assess how the jaws relate to each other, whether there will be a lack of space in the future and any possible deviations in the eruption of the teeth.
This checkup does not mean that every child needs to start treatment right away. In fact, for most children only regular monitoring is recommended after the examination. However, if treatment is needed, choosing the right time can reduce the need for longer and more complex treatment later. If your child is younger than 7 and has a noticeable jaw discrepancy, mouth breathing or a long-standing thumb-sucking habit, an earlier evaluation can also be done. We have also summarized the options by age in our article at what age can clear aligners be worn.
Which situations require early intervention?
Early (interceptive) orthodontic treatment is intervention carried out before a problem grows and while jaw development is still ongoing. It is usually done between ages 6 and 10, during the mixed dentition period. The following situations deserve attention in this respect:
- Crossbite: Some or all of the upper teeth closing inside the lower teeth. One-sided crossbites can cause the lower jaw to shift sideways and lead to asymmetrical development.
- Anterior crossbite and a forward lower jaw: In cases with a Class III tendency, where the upper jaw lags behind, early treatment is important.
- Markedly protruding upper front teeth: The risk of these teeth breaking in falls and knocks increases.
- Severe lack of space: When there is no room for the permanent teeth to erupt, they may remain impacted or come in in the wrong place.
- Open bite: The front teeth not touching each other, most often associated with thumb sucking or tongue thrusting.
- Early loss of baby teeth: If the space is not maintained, neighboring teeth can drift and close the space for the permanent tooth.
- Harmful habits: Prolonged thumb or pacifier sucking, lip biting, mouth breathing.
You can find a more detailed answer to why guiding growth matters in jaw relationship problems in our article can clear aligners correct jaw structure.
How are removable appliances and functional treatments used?
The tools most often used in early treatment for children are removable appliances and functional appliances that guide jaw development. Removable plates can move individual teeth or slowly widen a narrow palate using the screws and springs on them. The child takes this device out while eating and brushing and wears it for most of the day.
Functional appliances are used especially when the lower jaw lags behind. By holding the lower jaw further forward, they help the muscles and surrounding tissues adapt to this position. The skeletal effect of these appliances becomes noticeable during the growth spurt; for this reason, the timing is determined by the orthodontist based on X-rays and an assessment of hand-wrist development.
In cases where the upper jaw is narrow, rapid expansion appliances fixed to the palate may be preferred. Because the suture in the middle of the palatal bone has not yet fully fused at this stage, expansion is achieved more easily. In some cases where the upper jaw lags behind, a face mask worn at night may be recommended along with expansion.
When are braces placed in children?
Braces for children, that is, fixed bracket treatment, are usually planned after most of the permanent teeth have erupted, most often between the ages of 11 and 14. During this period, both the alignment of the teeth and the bite can be corrected together. In some early treatment cases, braces may be placed on the front teeth only, for a limited time.
During treatment with braces, special attention must be paid to the child's oral hygiene. Plaque that builds up around the brackets can lead to white spots on the enamel surface and to cavities. For this reason, children with braces are taught to use an interdental brush, limiting sugary and sticky foods is recommended and regular dental checkups are maintained. Parents keeping an eye on brushing, especially in the first months, greatly reduces the problems that can arise during treatment.
Can children use clear aligners?
Yes, there are clear aligner systems suited to specific ages and stages of dental development, and they can be used in children in suitable cases. Invisalign First, developed for children aged 6-10 in the mixed dentition period, can be an alternative to traditional appliances for jaw expansion and early alignment problems. For older children and teens, aligner systems that take erupting teeth into account are used. For details, you can see our pages on Invisalign First for children and Invisalign for teens.
The success of clear aligners in children depends on wearing the aligners for about 20-22 hours a day. For this reason, the family's involvement in the process is as important as the child's age and level of responsibility. Because the aligners are removable, brushing is easier; however, to keep them from getting lost, using a storage case at school and at meals should become a habit. Not every child is suitable for clear aligners; the decision is made after an examination and digital planning.
Is retention also necessary for children after treatment?
Yes, in children too, retention is needed after active treatment ends to maintain the result achieved. As long as growth continues, the jaws and teeth remain open to change; for this reason, the orthodontist usually recommends removable or clear retainers worn at night and, in some cases, thin fixed wires bonded behind the front teeth. Children who have had early treatment are monitored at regular intervals until all the permanent teeth have erupted, and whether a second phase of treatment is needed is assessed at these checkups. Neglecting the retention period can cause the result achieved through hard work to partially relapse.
Which signs should parents watch for?
Some signs you may notice at home can suggest that it is time for an orthodontic evaluation: teeth clearly overlapping, the lower or upper jaw looking shifted forward or backward when the mouth is closed, the jaw shifting sideways when chewing, snoring and sleeping with the mouth open, difficulty pronouncing certain sounds, and baby teeth falling out very early or very late. Noticing one of these signs does not mean there is a problem, but it can be a good reason to have an examination.
Orthodontic checkup for your child in Çankaya
If your child has turned 7 or you have noticed one of the signs above, you can schedule an evaluation with our orthodontist, Funda Pekyılmaz Sarıkaya, specialist orthodontist (Uzm. Dt.), at our clinic in Park Oran Ofis in Oran. During the examination, your child's tooth and jaw development is assessed; if treatment is needed, the most suitable timing and method, and if not, the monitoring interval, are determined together with your family.
Frequently asked questions
Can orthodontic treatment be done before the baby teeth fall out?
Yes, for some problems early intervention can be done before the baby teeth have fallen out. Crossbite, a narrow palate and differences in jaw development in particular are easier to guide during this period. However, not every child needs early treatment; the decision is made after an examination.
How many years do braces take for children?
Fixed braces treatment for children usually takes between 1.5 and 2.5 years. The duration varies depending on the severity of the problem, the child's growth and their compliance with treatment. In cases that have had early treatment, the second phase of treatment may be shorter.
Does early orthodontic treatment eliminate the need for braces later?
In some children, early treatment can eliminate the need for braces later; in others, it shortens and simplifies later treatment. The aim is to guide jaw development and tooth eruption in a more favorable direction. The outcome depends on the type of problem and the growth process.
Does thumb sucking damage the teeth?
If thumb sucking continues after age 4-5, gaps between the front teeth, open bite and narrowing of the palate can occur. The effect of the habit depends on its duration and intensity. If the habit cannot be broken, the orthodontist may recommend methods to support the child and, if necessary, a habit-breaking appliance.
