When should my child first see an orthodontist?

Parents often hear two different numbers: “bring your child at 7” and “braces usually start around 12”. Both are right, because they answer different questions. The first is about when to have a look. The second is about when treatment, if it is needed at all, usually begins.

1. Age 7First check-upA look at the teeth, the bite and jaw growth (AAO).
2. Age 7 to 11Growth is watchedEarly treatment only for specific problems.
3. Age 12 to 13Treatment usually startsFor most children who need it, once the adult teeth are through (BOS).

Why around age 7?

The American Association of Orthodontists (AAO) recommends that children have their first check-up with an orthodontist by about age 7. At that age most children have a mix of baby teeth and adult teeth: the first adult molars have usually come through, and the adult front teeth are arriving.

That mix tells an orthodontist a lot. It shows how the upper and lower teeth meet, whether there is likely to be enough space for the adult teeth still to come, and how the jaws are growing. Some problems are easier to recognise, and occasionally easier to manage, while a child is still growing.

The AAO also says that if your child is younger than 7 and something looks wrong, you do not need to wait.

What happens at a first check-up

A first orthodontic check-up is usually short and gentle. It typically includes:

• A conversation: what you have noticed, your child’s dental history, and habits such as thumb sucking.
• An examination of the teeth, the bite and the way the jaws close and move.
• Records only where they are needed: photographs or a scan are common. An X-ray is taken only if the orthodontist needs information that cannot be seen, for example whether adult teeth are present and where they are.
• An explanation of what was found, in words your child can follow too.

You should leave knowing whether anything needs to happen now, and if not, when the next look should be.

What usually happens next

There are three common outcomes:

First check-up

1. Nothing is neededThe teeth and bite are developing normally. Your family dentist continues routine care.
2. MonitoringSomething is worth watching, such as crowding or the way the bite is developing, but there is no benefit in acting yet. The orthodontist reviews your child every so often as the adult teeth arrive.
3. Treatment, now or laterA specific problem is found, and the orthodontist explains whether acting during growth helps or whether it is better to wait.

Monitoring is a common result. The British Orthodontic Society (BOS) notes that most children begin treatment around the age of 12 or 13, once their adult teeth have come through, and that in a few cases it is better started early.

When early treatment can help, and what the evidence says

Early (sometimes called interceptive) treatment is used for particular problems, not as a routine head start. Examples orthodontists commonly consider include:

• A crossbite that makes the lower jaw shift to one side when the teeth close together.
• Upper front teeth that stick out a long way, which are more exposed to knocks and falls.
• Space problems after a baby tooth is lost very early, where neighbouring teeth may drift into the gap.
• Habits such as prolonged thumb or finger sucking that are affecting the position of the teeth.

The evidence is useful here because it is honest about limits. A Cochrane review published in 2018 looked at children with prominent upper front teeth and compared treatment starting at about 7 to 11 years with a single course of treatment in adolescence. Early treatment reduced new injuries to the front teeth: in the trials using functional appliances, about 19% of children treated early had a new injury, compared with about 30% of those treated later. The review found no other lasting advantage, and it rated the evidence as low to moderate in quality.

In practice, that means early treatment is worth it when it solves a specific problem, and waiting is often just as good. Early treatment can also mean two phases of treatment rather than one, so the total time in treatment may be longer. A good assessment weighs both sides for your child.

Signs worth an earlier visit

You do not need to wait for a birthday if you notice:

• Baby teeth lost much earlier or later than usual
• Difficulty biting or chewing
• Front teeth that stick out, or lower front teeth that sit in front of the upper ones
• Teeth that do not meet when your child bites
• Mouth breathing, cheek biting, or a jaw that shifts or clicks
• Thumb or finger sucking continuing as the adult teeth come in

None of these means treatment is certain. They are reasons to have a look. Our child orthodontics page explains how assessments work for children and teens.

Risks and limitations

If treatment is recommended, it has risks like any treatment. They include tenderness for a few days after starting and after adjustments, tooth decay or gum inflammation if teeth are not kept clean, some shortening of tooth roots (usually minor), and teeth moving back if retainers are not worn afterwards. Children need help from a parent with cleaning and with wearing aligners or appliances as instructed. Growth can change the plan, and some children need a second phase of treatment later. Results vary from child to child and cannot be guaranteed.

In Dubai specifically

Invisalign Center Dubai, 697 Jumeirah Street, Umm Suqeim 2, where Dr Köni sees children by appointment.

• School calendar: a first check-up takes little time, but follow-up visits continue over months. Many families book the first visit in a school holiday so that any next steps can be planned around term.
• Summer travel: if your family spends long summers abroad, mention it at the first visit. It affects how reviews and any treatment are timed.
• Insurance: some UAE plans cover orthodontic treatment for children only in certain circumstances or up to a limit. Check your policy before treatment starts, and ask the clinic for the documents your insurer needs.
• Language: a child is more relaxed when they understand what is happening. Dr Köni consults in English and Turkish.

Clear aligners and fixed braces are both used for children and teens; our braces and clear aligners page explains the difference. If you would like Dr Berk Köni, a specialist orthodontist in Dubai, to see your child at Invisalign Center Dubai in Umm Suqeim 2, you can send a message through the enquiry form with your child’s age and what you have noticed.