Parents are often surprised to hear that an orthodontist may want to see a child long before all the permanent teeth are in. The American Association of Orthodontists (AAO) encourages parents to take children for an orthodontic check by age 7. That does not mean braces at age 7. It means having a specialist look at how the teeth and jaws are developing while there is still growth to work with. This guide explains what that first visit is for, the possible outcomes, and what to ask.
Why age 7?
The AAO says encouraging parents to bring children to an orthodontist by age seven is part of its consumer awareness campaign, and that an early visit can help maintain oral health and may help avoid more costly or invasive treatment later (AAO: When should my child see an orthodontist?). Around this age, children usually have a mix of baby and permanent teeth, so an orthodontist can see how the adult teeth are arriving and how the jaws are growing. MouthHealthy’s eruption charts show the general timing of when baby teeth are lost and permanent teeth come in (MouthHealthy: Eruption charts); our baby teeth timeline summarizes it.
Three possible outcomes
The AAO is clear that not all early visits result in treatment. It describes three possibilities:
- No treatment is needed at that time.
- Treatment may be needed in the future, so the child is monitored periodically while the face and jaws continue to develop.
- A problem that would benefit from early treatment already exists, and a plan can begin.
For many families the result is simply a baseline and a recommendation to come back later. That can be reassuring in itself.
What early treatment can involve
When early (“interceptive”) treatment is recommended, the AAO gives several examples:
Palatal expansion
A palatal expander can widen the upper jaw and help reduce crowding in abnormally narrow arches. The AAO explains that it is ideally used while a patient is still growing, because expansion works by stretching the growth suture in the middle of the palate. It notes that in younger patients, expansion may reduce the need for extractions or help prevent impacted teeth, while cases not corrected during growth may require surgery in adulthood.
Short-term braces
The AAO says early intervention such as wearing braces for a short time can correct some problems before they become more severe. It gives correcting an anterior crossbite, where upper front teeth sit behind the lower ones, as an example.
Removing baby or impacted teeth
Sometimes removing certain baby teeth or impacted teeth can help permanent teeth come in closer to their ideal position, even without an appliance. The AAO notes the orthodontist will time this to take advantage of growth.
Signs worth mentioning to your dentist
You don’t need to wait for a problem to book a check, but these observations are useful to share. MouthHealthy explains that orthodontics treats problems such as crooked or crowded teeth and bites that don’t line up properly (MouthHealthy: Orthodontics).
- Crowded, overlapping or widely spaced teeth
- Front teeth that stick out or don’t meet
- Upper teeth that sit inside the lower teeth when biting
- A jaw that shifts to one side when closing
- Baby teeth lost very early or very late
- Ongoing thumb sucking or mouth breathing
- Difficulty chewing or biting
Your general or pediatric dentist sees your child regularly and can often spot these early and suggest a referral. Our guide to dental specialists explains how orthodontists’ training differs from a general dentist’s.
What happens at the first visit
An early orthodontic evaluation usually involves looking at the teeth, bite and jaw growth, and may include photos or X-rays. The orthodontist then explains which of the three outcomes above applies and, if treatment is suggested, why now rather than later. The AAO notes that many orthodontists offer free consultations and early evaluations for children, but policies differ, so ask when you book. Our dental X-rays guide explains common types of images and their safety.
Questions to ask the orthodontist
- Is there anything that needs treatment now, and what happens if we wait?
- If we monitor, how often should we come back?
- Will early treatment shorten or replace later treatment, or is a second phase likely?
- What appliance would be used, and how long would it be worn?
- What will my child need to do at home, and how will we care for the teeth around the appliance?
- What is the total estimated cost, and what does it include?
If you have dental insurance, ask your plan what orthodontic benefits it includes before you agree to treatment. Our dental insurance guide explains key terms.
Braces later on
Most comprehensive treatment with braces or aligners still happens once more permanent teeth are in. MouthHealthy’s braces page explains how braces apply gentle pressure over time to move teeth (MouthHealthy: Braces). If your child is older, our comparison of clear aligners and braces covers the questions to ask. Whatever the approach, results are kept in place with a retainer; see our guide to retainers after braces.
How families can prepare
Before the visit, jot down anything you have noticed about your child’s teeth, bite, speech, breathing or habits, and bring a list of medicines and any recent dental X-rays if your dentist can share them. Let your child know the visit is mostly looking and counting teeth, so it doesn’t feel like a big event. Afterward, ask for any recommendations in writing, including when to come back if the plan is to monitor.
If treatment is recommended, it is reasonable to take time to decide, and to get a second view for a large plan. Our guide to getting a second opinion explains how. Early treatment also tends to work best when the child is on board, so involve them in the conversation in an age-appropriate way.
Daily care during early treatment
Appliances like expanders and short-term braces create new places for food and plaque to hide. Your orthodontist will show you how to clean around them. Keep up regular checkups with your child’s dentist during treatment, since the orthodontist focuses on alignment while the dentist watches for cavities and gum health.
Frequently asked questions
Does an orthodontic check at 7 mean my child will get braces?
No. The AAO says not all early visits result in treatment. Many children are simply monitored.
Can braces go on while a child still has baby teeth?
In some cases, short-term early treatment is used for specific problems. The orthodontist will explain whether that applies to your child.
Do I need a referral?
Many orthodontists see patients without one, but your child’s dentist can recommend whether and when to go. Check your insurance rules too.
Why treat early instead of waiting?
The AAO explains that some problems, like a narrow upper jaw, are easier to address while a child is still growing.
Is it too late if my child is older than 7?
No. Age 7 is a suggested time for a first check, not a cutoff. Orthodontic treatment is possible at any age.
Sources
- American Association of Orthodontists: When should my child see an orthodontist?
- MouthHealthy (ADA): Orthodontics
- MouthHealthy (ADA): Braces
- MouthHealthy (ADA): Eruption charts
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “A boy wearing dental braces” by João Paulo Sousa, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.