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When should orthodontic treatment be started?
The most confusing question for most parents, and some general dentists, is when to actually start treatment. The objective is to treat at the time when it will minimize treatment time, achieve a normal profile, and eliminate the need to extract permanent teeth.
In our practice the way we get great profiles is to start full treatment at the beginning of the maximum growth spurt. When there are severe deforming problems, then you may wish to start much earlier or do treatment in two stages. Two stage treatment: treat bone related problems early at age 7-9, and possibly full braces at age 11-12. However, typically treatment is a one stage affair at age 11 or 12. Go look at the section on How Kids Grow at this point and then come back to read the rest of this article.
Bottom line: if there are no unusual circumstances, then normally the first visit to the orthodontist should be at age 10 for girls and age 11 for boys.
Age seven
If your child doesn't look like his or her peers, it may be time to get an opinion from an orthodontist. Sometimes, general dentists just don't understand the importance of early treatment and will "hold" kids until all the permanent teeth have erupted. This is the worst possible answer.
If there is crowding, two rows of teeth in the lower arch or protrusion of the upper teeth, get an opinion from an orthodontist who understands growth and development.
If the lower jaw appears retruded, it may be time to see if there is a Class II growth pattern.
If there is a crossbite of the front or back teeth, this is an indication to treat early.
Help is happily given by brothers and sisters in our office (mostly by sisters!!!)
Age eleven
This is the more typical time to start orthodontic treatment. Again it is essential that you do not wait on full eruption of the permanent teeth. The objective is to treat the child during maximum growth and avoid the extraction of permanent teeth. This can only be done when the last of the baby teeth remain.
If there is peer pressure due to an abnormal appearance or teasing by school mates.
With girls, it is important to start early as they typically mature at least one year earlier than boys.
With boys, you may have to wait a little later as their growth and development is normally later, but the test is how many baby teeth are left. You want to begin treatment before the last of the baby teeth are lost.
We are more than happy to see your child for a consultation in our offices, but we cannot make decisions or offer advice on the Internet. Obviously, personal contact with the parent and child is necessary.
