At what age should my child see an orthodontist?

This is one of the most common questions I am asked. While there is no single ‘correct’ answer for every child, there are guidelines that can be applied in assisting with your decision. In an attempt to provide you with guidance, it is worthwhile to consider at what age can orthodontic treatment begin?

There are few indications for a child to begin orthodontic treatment when only the baby teeth [deciduous dentition] are present. The average age at which the permanent teeth begin to erupt is around 6 years of age. This means for most children a visit to the orthodontist before this age is not required.

As the baby teeth fall out and the permanent teeth begin to appear, problems can arise. For want of a better word, disturbances, which occur around this time, can be termed eruption problems.

The first adult teeth to appear in the mouth are usually the adult first [6 year old] molars. These teeth do not replace any baby teeth. Soon thereafter, within a space of a few years [6-8 years of age on average], the four adult front teeth in the upper and lower jaws emerge.

Ectopic eruption refers to the appearance of the adult tooth in the wrong place within the mouth. A baby tooth that is meant to fall out as its adult replacement is appearing in the mouth can lead to the adult tooth being displaced from its intended position within the mouth. Such over-retained baby teeth usually first become apparent when the adult front teeth are appearing.

Supernumerary teeth [extra teeth] often are found in the upper jaw just behind the front teeth. These extra teeth can prevent or dramatically slow the appearance of the adult front teeth. They are usually discovered on x-rays, which are taken to find out why the adult front teeth have not appeared.

With the appearance of the first [6 year old] adult molars and the adult front teeth, problems such ascrowding and buckiness of the top teeth can be readily assessed. An assessment can be made at this time as to the appropriateness or otherwise of early orthodontic treatment.

Thumbsucking or finger sucking habits, which may have been tolerated in the past, should now become unacceptable. Parents and siblings will often notice the distorted appearance of the upper front teeth, especially as the larger adult front teeth appear within the mouth. The effect of thumbsucking is not only limited to the teeth but can also extend to the development of the underlying jawbone.

It is perhaps fortunate that around the same time as many of the above problems are occurring, social and behavioural development has reached a stage such that most children can now tolerate orthodontic treatment.

For these and other reasons, I would recommend you consider having your child examined by an orthodontist around 8 years of age. While treatment may not be required, early examination should provide you with peace of mind.

If treatment is required, this can be undertaken at that time or planned for so as to enable the best outcome for your child. While early treatment cannot guarantee your child of not requiring further treatment in their teenage years, it can certainly avoid such future treatment or at the very least simplify this treatment. Early treatment can also avoid the need for future removal of adult teeth as part of the orthodontic correction.

Education of dentists is equally important for your child’s dental care. It is for these reasons that I provide my referring dentists with information aimed at educating and informing them about orthodontic treatment and what to look out for. If you fall outside this network, don’t worry, a referral from a dentist is not required to see an orthodontist.