AGE 6-7
The American Association of Orthodontists recommends that all children be seen by the age of 7.Yes, that sounds self serving, but orthodontic problems may not be obvious just by glancing. Wouldn't you rather know if something is up? Some parents argue that they didn't see the orthodontist until they were 12 or 13. These are the same parents who miss cassette tapes for music. Old school. We now treat early because it's more effective and we get a better long term result. Certainly every child does not need interceptive treatment. It's just nice to know for sure.
Many parents will wait for the dentist to give them the go-ahead to schedule an orthodontic exam. Some dentists are great at screening, but some haven't thought about orthodontics since dental school. I know a dentist who didn't send her own daughter for an evaluation until it was obvious that a tooth was completely blocked out. She told me that she learned in dental school that the orthodontists could address problems at any age. Yes, we do treat problems at any age, but I'd rather take care of something at the right time. A dentist who fails to refer for an evaluation is not practicing to the Standard of Care.
By age seven the upper and lower incisors should have erupted. If they haven't erupted, it doesn't mean that something is wrong, but we discover teeth unable to erupt due to lack of space all the time. Worse, we find that teeth are missing. Missing teeth are far more common than anyone believes. I see new patients in my office every week who have missing teeth. Most of them didn't know the teeth were absent. The only way to properly evaluate unerupted teeth is to have a panoramic x-ray taken. Missing teeth require planning.
Indications for Early Treatment (Interceptive Orthodontics)
- Crossbites- The upper and lower teeth don't meet properly.
- Crowding- Not enough room for teeth to erupt.
- Jaw discrepancy- Poor relationship of the upper to lower jaw
- Protrusive upper teeth (Buck teeth)
- Regaining space lost by early loss of primary teeth
- Harmful oral habits
- Self conciousness or low self esteem due to smile
- Extra space between teeth
- Mildly excess overjet (front to back distance of upper to lower front teeth)
- Mildly excess overbite (vertical overlap of front teeth)
- Jaw position which will improve with normal growth
- Kids who want treatment because their friends have it or they think it's coolAge
AGE 8-11
If you missed the boat on early treatment, it's not too late to get onboard. As I posted earlier, chronologic age matters less than dental age. We can still do many of the interceptive treatments and make things easier when every tooth has emerged. At some point is makes more sense to do one phase of treatment, comprehensive. Again, an exam can go a long way to exploring orthodontic treatment options. Keep in mind that the older the patient, the more limited the treatment options may be.AGE 12-15
If your child hasn't been evaluated, time is running out. Get off the computer and call an orthodontic office, now. No, I mean stop reading and come back to this later, or you'l just keep putting it off until you run into the next age range.
AGE 16-18
One of the significant treatment options is now lost, the expander. Expanders can no longer be effectively used. Yes, some practitioners use them this late, but the biologic basis for their use has past. If one is used now, it hurts like heck and is very uncomfortable. Patients seeking treatment at this age are generally self motivated. They have issues with their smile and want treatment. Invisalign Teen can be used, and ceramic (clear) braces are always on option.
Summary
When is the best time to have an orthodontic evaluation? Now. Earlier is better. Even is nothing needs to be done, you'll have peace of mind. By the way, most orthodontic offices do not charge for an exam. It will only cost you some time, but you'll have invaluable information.This post is not intended to replace the advice of your local orthodontist and is provided for informational purposes only.
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