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At What Age Should I Bring My Child In For An Orthodontic Consultation?

04/10/2014, 6:45pm CDT
By djr

This is one of the most common questions that people ask me.  This question has several variations which include:  Why are people getting braces so young now days? Or didn't people used to get braces when they were in middle school?

No matter how it is phrased, what parents really want to know is why some people are getting braces in 2nd ,3rd or 4th grade and others are getting their braces in 7th or 8th grade.  Naturally, they also want to know in which of these groups their child belongs. 

Many parents believe they must wait until their child has all of his or her permanent teeth before orthodontic treatment can begin, only to find that treatment sometimes would have been much easier if they had started earlier. In general, we like to see children for an orthodontic assessment at the age of 7 or 8 years old. This is an important time to address any orthodontic issue. Some orthodontic problems at that age , if left untreated or delayed, can lead to increased difficulty in correcting the problem, less stable results, abnormal jaw growth, abnormal tooth wear, or increased risk of chipping a tooth.

To understand the answer to that question, it is important to understand something about dental development.  Most children begin losing their front teeth at about 6 years of age.  By 8 or 9 years old, eight permanent front (incisor) teeth have replaced the front baby teeth.  At the same time, four new permanent molars are growing in behind the back baby molars.  So at about 8 or 9 years old, a child usually has twelve permanent teeth and twelve baby teeth in the mouth at the same time.  In dentistry this is called "the mixed dentition" because there is a mix of permanent and baby teeth.

At this point, there is typically a window of 2-3 years before the child will lose anymore baby teeth. 

It is also at this time that problems of crowding and misalignment of the front teeth become apparent because the size of the permanent teeth is so much larger than the teeth that they replace.  Children who did not have spaces between their baby teeth will develop crowding of the front teeth simply because the permanent teeth are so much bigger.  Because of the development of these and other problems as the new teeth grow in, it is the time when "early intervention" or "phase I treatment" is usually performed.  Because only half of the permanent teeth have grown in, only partial orthodontic treatment can be rendered at this stage.  It 

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