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A child should see an orthodontist around age six or seven, when the first permanent molars and front teeth are coming in, long before most children get braces. The visit looks at how the jaws are growing and how the adult teeth are coming in, while there is still time to guide both. Most children seen at that age need only a recheck. A few have problems that are far easier to fix at eight than at fourteen. At Vizcaya Dental Arts those evaluations are done by Dr. Patricia Hong, a board-certified orthodontist, and they are complimentary.
When to bring your child
Around six or seven, when the first permanent molars and the front teeth are coming in; the American Association of Orthodontists recommends a first check by age seven. Sooner if you notice something:
- Front teeth that stick out
- A lower jaw that sits ahead of the upper teeth when biting
- A crossbite, where upper teeth close inside the lower ones
- Thumb or finger sucking that has not stopped
- Mouth breathing
- Baby teeth lost very early or very late
- Difficulty chewing or biting
- Teeth that are visibly crowded or spaced
Your pediatric dentist may also refer you.
What the evaluation finds
Dr. Hong looks at the bite, the width of the jaws, the space available for the adult teeth that have not come in yet, habits, and the way the child breathes and swallows, with X-rays when they add something. From that she can usually place the child in one of three groups.
Nothing to do yet, keep an eye on it. By far the largest group. The child comes back every six to twelve months as the teeth erupt, and if treatment is needed it starts in the early teens, once most of the adult teeth are in. Monitoring visits are free.
A short early phase would help. For specific problems, treating early prevents a bigger problem later: a crossbite that is shifting the jaw, a narrow upper jaw, severely crowded or protruding front teeth at risk of injury, a habit that needs breaking. Early treatment aims to fix that one thing, with the rest of the alignment left for the teenage years.
A problem that needs timing. Some growth-related bite problems are best treated during a particular growth window, and the evaluation sets the calendar so it is not missed.
Dr. Hong explains which group your child is in and why.
Phases, and what each one does
When early treatment is recommended, it is a first phase with a specific aim. The appliances depend on the problem: an expander to widen a narrow upper jaw, partial braces on the front teeth to align or protect them, a small appliance to stop a habit. The phase lasts months rather than years, and it is followed by monitoring while the remaining adult teeth come in. Most children who have a first phase still need a second, shorter, more complete phase of braces or aligners as teenagers, and the fee for each phase is explained separately.
Teenagers: braces or Invisalign Teen
Most orthodontic treatment happens between about eleven and fifteen, once the adult teeth are in and growth can still be used. Braces, metal or clear, remain the most complete tool and cannot be left out. Invisalign Teen is designed for growing mouths, with room for erupting teeth and wear indicators on the trays that show whether they are being worn, and it suits many teenage cases at a similar cost to braces. The right choice depends on the case, on the teenager’s habits and on how the family can support treatment. Our braces and Invisalign pages describe each.
Everyday concerns
Cleaning. Braces make brushing harder and the stakes higher: plaque left around brackets leaves permanent white marks on the enamel. We show the child, and the parent, how to clean, and we check every visit.
Sports. A mouthguard made for braces protects the lips, cheeks and the appliance in any sport where a blow is possible. We make them; see athletic mouthguards.
Breakages and missed visits. A loose bracket or poking wire is covered with wax and seen within a few days. Missed adjustment visits are the most common reason treatment runs long, so the calendar matters.
Responsibilities. The child or teenager wears the elastics or aligners and keeps the teeth clean, and the parent keeps the appointments and watches the wear time.
Not a pediatric dental office
Vizcaya Dental Arts does not provide pediatric general dentistry. Young children keep their pediatric dentist for cleanings, fillings and checkups, and we coordinate with that office during orthodontic treatment. Children usually move to us for general care at about age ten, when most of the adult teeth are in. Our general and family dentistry page explains who we care for.
After treatment
Retainers hold the result while the face finishes growing and for the long term afterward, and a teenager’s retainer habit is the difference between a lasting result and an adult relapse case. Our retainers page explains the types and the wearing schedule.
Frequently asked questions
At what age should my child see an orthodontist?
Around six or seven, once the first permanent molars and front teeth are coming in. The American Association of Orthodontists recommends a first check by age seven. Most children seen at that age need nothing yet; the point is to catch the few problems that are easier to fix while the jaws are growing.
Does an early evaluation mean early braces?
Usually not. Most children are simply monitored, with a short visit every six to twelve months as the teeth come in, and treated once in their early teens if treatment is needed at all. Early treatment is reserved for specific problems where waiting would make things harder.
Braces or Invisalign for a teenager?
Both work for many teenage cases. Braces cannot be forgotten in a drawer; aligners can, so the honest conversation is about the case and about the teenager. Dr. Hong talks it through with the family and recommends one.
Does the practice do children's cleanings and fillings?
Not for young children. Vizcaya Dental Arts is not a pediatric dental office; children usually move to us for general care at about age ten. Until then your child keeps their pediatric dentist for cleanings and checkups while Dr. Hong handles the orthodontics, and the two coordinate.
How much does children's orthodontics cost?
It depends on whether treatment is in one phase or two and on the appliances involved. The consultation is complimentary, the estimate is written, and treatment is paid with a down payment and interest-free monthly installments arranged with the office.
Can my child play sports in braces?
Yes, with a mouthguard made for braces, which we make. Brackets cut lips and cheeks badly in a collision, and a guard designed to sit over them protects both.
Sources
Professional guidelines and peer-reviewed reviews this page draws on.
- American Association of Orthodontists. Orthodontics for children: developing a healthy smile. Recommends a first orthodontic check-up no later than age 7. AAO
