When Should Your Child See An Orthodontist?

young girl with glasses taking a selfie

Let’s try a little experiment – close your eyes and imagine someone wearing braces. Is it a teenager’s face you see? A tween? Maybe even an adult?

When we think of orthodontic treatments, especially traditional metal braces, we almost always picture older children and teens. So it might surprise you to learn that the American Association of Orthodontists actually recommends children have their first check-up with an orthodontist no later than the age of 7. This may seem counter-intuitive since most children that age still have their baby teeth and still have developing mouths. Why such an early recommendation, then? Let’s explore the topic and find out!

Picking up potential issues early on

The transition we all go through from baby teeth to permanent teeth is an especially important one. Where our baby teeth are located and when they fall out sets the foundation for our permanent teeth, and where their ultimate position in our mouths will be. Having an orthodontic exam by around age 7 means your orthodontist can pick up on any potential issues early enough that a great deal of negative impact to the permanent teeth can be prevented.

What will your orthodontist be looking for?

There are many dental issues your orthodontist will check your child for when they have their first orthodontic appointment. There are, however, several common problems that show up in childhood that your orthodontist will be paying special attention to, such as

Tooth Loss and Eruption

blonde girl with pig tails missing teeth

Our baby teeth normally fall out in a fairly specific order, so if your orthodontist notices that your child has any significant deviation from this pattern, it may indicate that there are developmental issues that need attention.

By the age of 7, we are looking for children to have at least four permanent molars, as well as two to four permanent incisors. If your child has more or less than this, there may be future problems with missing, crowding, or extra teeth. Sometimes your orthodontist will choose to remove a primary tooth early or maintain a space where a tooth has been lost prematurely in order to prevent these from becoming bigger problems later on down the line.

Crowding and Spacing

By the time your child is around the age of 7, it will be possible for your orthodontist to tell if they have had or will have any problems with overcrowding or excessive spacing. Spacing issues will often arise over a tooth that’s been lost prematurely, one that’s never developed, or teeth that are too small or too spaced apart. Crowding can sometimes require expanding the arches or removing certain teeth to make more room.


Although teeth can be and often are aligned at an older age, your orthodontist will want to keep an eye on any visibly crooked teeth when your child has their first appointment. Teeth that are misaligned are more likely to experience uneven damage and wear, and over time, this can cause the shape and position of the surrounding gum tissue to be compromised.


By the time a child is 7, it will generally be quite obvious if their front teeth stick out more than is safe or deemed attractive. Although it’s not always possible to permanently correct an overbite until your child’s mouth has finished growing, a good orthodontist will have ways to help reduce the severity of the problem. This can at least make things easier for them until growth is complete.


Underbites can be the result of both tooth or jaw problems. The most difficult scenario we see is when the lower jaw grows too far forward. In those types of cases, we’ll typically have to wait until the patient has finished growing to finish their treatment. This will usually mean waiting until the patient is 16 or older.

That said, early treatment is actually of great importance with these patients! Normalizing this bite as much as possible, as early as possible, will help avoid some bite-shifting and damage to the front teeth. Sometimes orthodontists who notice an underbite in a young patient will want to “jump the bite” with braces or headgear to try and get a handle on it, before then completing treatment in their teenage years. This will vary from practice to practice, of course.

Note: underbite patients who receive early treatment between the ages of 7 and 10 are much less likely to need jaw surgery at an older age. That’s one big reason why it’s so strongly recommended your child see an orthodontist by age 7!

Posterior Crossbites

Posterior crossbites can be a cause of crowding and may also cause the jaw to shift from one side to the other. Sometimes expanding the upper jaw from around the ages of 7 to 10 can reduce that crowding and create space necessary for the eruption of the front teeth. It may also eliminate any shifting present due to a constricted upper jaw.

Anterior Open Bites and Deep Bites

By age 7, it’s possible to detect vertical problems with the bite. Bites that are too deep (where the top teeth completely cover the bottom ones when biting) can indicate the patient has a small lower jaw, and bites that don’t overlap enough (open bites) may be a sign that there is an oral habit causing dental problems. We encourage our patients to eliminate these destructive habits early so that normal development will be allowed to occur!

Earlier is better

young girl with braces smiling

For all the reasons listed above and more, early orthodontic evaluations are important in order to give your child their best chance for a healthy, straight smile! Most children will lose all their baby teeth by the age of 13 or so, and by the end of their teen years, their jaw bones will harden and stop growing. After this point, orthodontic procedures will often take more time, and can sometimes involve tooth extraction or even oral surgery.

Having received early orthodontic treatment can help prevent the need for it as an adult, reducing the need for more invasive and painful procedures, and although some treatments will have to wait until all the permanent teeth are in, interceptive treatment can make comprehensive treatment faster and better. It also gives your child the benefit of getting a head start on a healthy smile at an age when their self-image is developing, and their self-esteem is budding.

Szymanowski Orthodontics and your child’s smile

Dr. Damon and the team

Early evaluations aren’t the only important part of your child’s developing smile, however. You want to be sure and choose an experienced orthodontist who is highly trained, skilled, and on top of the latest orthodontic technology and equipment. Here at Szymanowski Orthodontics, we provide our Sacramento patients with exceptional care and service, using a multi-disciplinary approach to produce unparalleled results.

If you’re in the Sacramento area and have a child around the age of 7 who hasn’t yet seen an orthodontist, contact us today to set up a complimentary consultation for them. Remember, the sooner your child is evaluated, the better their chances for a beautiful, straight, and healthy smile as they head into adulthood! We look forward to helping them achieve that.