At what age should children see an orthodontist?

I am concerned about the way my child's teeth are coming through but they still have some baby teeth. Is it too early to see an orthodontist?

Many people have the opinion that it is not worth visiting an orthodontist before all the baby teeth have fallen out. This is because, the traditional fixed (train-track type) braces can only be used for adult teeth. 

However, there are situations where it is better to see an orthodontist earlier. 

The adult teeth start coming through from around 6 years old and if there are any concerns an orthodontic assessment can be done between the age of 7-9 years.

For some orthodontic problems treatment can be started before all the adult teeth have come through.

Which orthodontic problems may be suitable for early diagnosis and treatment?

• Baby teeth removed early - other teeth may tilt into or take up the vacant space, causing the permanent teeth to come through crooked. Using a space maintainer can prevent more complicated and costly treatment later on.

• Protruding front teeth - which can be prone to accidental injury.

• Open bites - teeth not meeting when biting together.

Upper incisor tooth in "cross-bite" behind lower incisor

• Cross bites - upper teeth coming through behind the lower teeth.

• Difficulty in biting or chewing.

• Growth discrepancies of the jaws and/or teeth out of proportion.

• Some cases of crowding - not enough space for all the adult teeth.

• Missing teeth - sometimes teeth are absent from birth (they just do not grow). An x-ray would be needed to confirm the tooth or teeth are missing. A decision can be made to either close the space or maintain the space for dental implants later.

• Adult teeth under the gum that do not come through within the normal age range - the cause can be investigated and treated. 

• Large gap between the upper front teeth (diastema) - investigation and treatment is often more successful if done earlier.

• Asymmetrical smile

• Persistent thumb or finger-sucking habits - see previous blog for more information. 

What are the goals of early orthodontic intervention?

• Make room for permanent teeth to come through and guide them into the correct position.
• In the case of jaws which are out of proportion, functional appliances can guide the growth of the jaws and correct certain bite problems.
• For simpler problems, later orthodontic treatment may be avoided.
• Potentially simplify and shorten later comprehensive orthodontic treatment  for more complex cases.
• Improve personal appearance and self esteem.

If you are unsure, it is best to see your dentist for a check-up first - they will be able to advise you whether your child would benefit from an early assessment with an orthodontist.