When Should My Child Have an Orthodontic Evaluation?

If your child’s permanent teeth are starting to come in crooked, crowded or differently than you expected, you may wonder whether it is already time for an orthodontic evaluation.

You do not necessarily need to wait until all of the permanent teeth have erupted. The American Association of Orthodontists recommends that children have an orthodontic checkup no later than age 7.

That does not mean every 7-year-old needs braces. An early evaluation can help determine whether your child’s teeth and jaws are developing normally, whether a problem should simply be monitored, or whether there may be a reason to consider treatment earlier.

Why Is Age 7 Important?

Around this stage of development, many children have a mixture of baby teeth and permanent teeth. That can give a dental professional useful information about how the permanent teeth are erupting and how the upper and lower jaws are developing together.

Some orthodontic concerns become easier to recognize during this mixed-dentition stage, even though many permanent teeth have not yet come in.

An evaluation at this age is therefore often about watching development and identifying potential problems early — not immediately putting a child in braces.

What Signs Might Mean My Child Should Be Evaluated?

You do not have to diagnose an orthodontic problem yourself. However, certain things may be worth discussing with your dentist:

If you notice something that concerns you before age 7, you do not need to wait for a particular birthday to ask about it.

Does an Orthodontic Evaluation Mean My Child Needs Braces?

No.

This is one of the most important things for parents to understand. An orthodontic evaluation and orthodontic treatment are not the same thing.

For many children, the recommendation after an evaluation may simply be to continue monitoring growth and tooth eruption until the timing is more appropriate for treatment.

Other children may have a developing problem where earlier treatment could be considered.

The purpose of evaluating early is to understand what is happening — not to treat every child early.

Why Would Some Children Need Earlier Treatment?

Certain orthodontic problems may benefit from attention while a child is still growing and the teeth and jaws are developing.

Depending on the individual problem, earlier treatment may sometimes be considered to address bite relationships, guide dental development, manage space or reduce the risk associated with certain tooth positions.

But early treatment is not appropriate for every orthodontic problem. The decision depends on your child’s specific diagnosis and stage of development.

What If My Child’s Permanent Teeth Are Coming In Crooked?

Permanent teeth do not always erupt in perfectly straight positions. Crowding or temporary irregularity can become noticeable as children transition from baby teeth to permanent teeth.

Whether crooked teeth need treatment depends on factors such as available space, the position of the teeth, the bite and how your child’s mouth continues to develop.

If you are seeing crooked permanent teeth, bring it up at your child’s dental examination rather than trying to determine from appearance alone whether braces are needed.

Read
Is It Normal for My Child’s Permanent Teeth to Come In Crooked?

What If an Adult Tooth Is Coming In Behind a Baby Tooth?

Sometimes a permanent tooth begins erupting behind a baby tooth that has not yet fallen out. Parents may notice what looks like a second row of teeth.

This does not automatically mean your child needs orthodontic treatment or that the baby tooth must immediately be removed. The next step depends on factors such as whether the baby tooth is loose, where the permanent tooth is erupting and how the teeth are developing.

Read
My Child’s Adult Tooth Is Coming In Behind a Baby Tooth — What Should I Do?

What Happens During an Orthodontic Evaluation?

An orthodontic evaluation looks at more than whether individual teeth appear straight.

The clinician may evaluate how the upper and lower teeth fit together, the amount of space available for developing teeth, tooth eruption and the relationship of the jaws.

Dental photographs, X-rays or other records may be recommended when they are clinically useful. Imaging should be based on the individual child’s diagnostic needs rather than automatically performed simply because an orthodontic evaluation is taking place.

For more about dental imaging in children, read
Does My Child Need Dental X-Rays? Are They Safe?

Should I Ask My Child’s Regular Dentist First?

Yes. Your child’s regular dental visits provide an opportunity to monitor how baby teeth are being lost, how permanent teeth are erupting and how the bite is developing.

If something appears to need a more specialized orthodontic evaluation, your dentist can discuss that with you and recommend the appropriate next step.

If you’re wondering how often your child should be seen for regular dental care, read
How Often Should Kids Go to the Dentist?

Don’t Wait for All the Adult Teeth to Come In Before Asking

Parents sometimes assume orthodontics cannot be evaluated until all of a child’s permanent teeth have erupted.

That is not the case.

An earlier evaluation can identify developing concerns while still allowing the dentist or orthodontist to recommend waiting and monitoring when that is the better choice.

If your child is around age 7 and you have never discussed their bite or dental development, it is reasonable to bring it up at the next dental visit.

Children’s Dental Care Near Beaverton

Cedar Hills Dental Care provides family dentistry for children and adults near Beaverton. Our practice has served the community since 1986 and has cared for more than 10,000 smiles.

Christine Chin, DMD brings more than 35 years of dental experience and is an Oregon Health & Science University-educated dentist. Regular dental visits allow us to follow your child’s oral health and dental development as they grow.

If you have noticed crowding, unusual tooth eruption or something about your child’s bite that concerns you, ask us about it. We can evaluate your child’s dental development and discuss whether monitoring or a more specialized orthodontic evaluation may be appropriate.

Learn more about our
Dental Care for Children
and our growing collection of resources for parents.

Further Reading for Parents

If you have questions about your child’s permanent teeth, bite or dental development, these Cedar Hills Dental Care articles may also help:

• Is It Normal for My Child’s Permanent Teeth to Come In Crooked?
• My Child’s Adult Tooth Is Coming In Behind a Baby Tooth — What Should I Do?
• Does My Child Need Dental X-Rays? Are They Safe?
• How Often Should Kids Go to the Dentist?
• Dental Care for Children: Prevention, Development & Lifelong Oral Health