Orthodontic Treatment: An Age-By-Age Guide
For most children, an initial visit to the orthodontist at age 7 will be low-key and inexpensive, says Don Joondeph, D.D.S, M.S., an orthodontics professor and member of the American Association of Orthodontists. Often the strategy, Joondeph says, will be a “wait and see” approach.

Here is an age-by-age guide of what to expect from orthodontic evaluation and treatment.

    T face=Verdana>Ages 2 to 3 – In very rare cases, children as young as 2 or 3 with extremely distorted bites may need to begin treatment.

    T face=Verdana>Ages 5 to 7 – This is the ideal time to counsel children to stop bad habits, such as thumb-sucking and tongue-thrusting, according to Jeffrey Ahlin, D.D.S., who has taught at Tufts and Harvard universities and is the online editor for the American Orthodontic Society. Although most malocclusions are hereditary, habits can make problems worse if they continue after permanent teeth have come in.

    T face=Verdana>Ages 6 to 8 – This is the time to correct crossbite (when teeth overlap each other, most commonly when the upper teeth bite inside the lower teeth, toward the tongue), Ahlin says. This condition makes it difficult for children to bite and chew properly. If the lower jaw is jutting out, the upper jaw will need to be brought forward, and the window of opportunity for doing that is at a young age, Joondeph notes.

  • Ages 8 to 10 – This is the target age range for correcting most other jaw problems connected with overbites, protruding upper teeth or open bites (upper and lower front teeth do not touch when back teeth are biting down).

    “I usually try to get to the skeletal parts of the problem first, at age
    8 to 10, before putting on the brackets, if needed,” Ahlin says.

    Sometimes a child will have headaches because the muscle next to the temple is connected to the lower jaw and gets a kind of “charlie horse” if the jaw is misaligned, Ahlin explains. In those cases, treatment should begin at the younger end of the age range.

    The orthodontist will use fixed or movable appliances to widen the jaw or change its alignment. For example, a headgear, the most common of several appliances used to correct jaw-growth problems, is often used to correct an overbite, usually caused by the lower jaw being too short. Usually worn for 10 to 12 hours a day, a headgear slows the growth of the upper jaw by putting backward pressure on the upper teeth, allowing the lower jaw to catch up, Joondeph explains. Other appliances may advance – or push forward – the lower jaw, opening up the airway and preventing later problems with snoring or sleep apnea, Ahlin says.

  • Ages 10 to 13 (before braces go on) – It is usually best to begin to deal with crowded teeth caused by the dental arch being too small and/or teeth being too big before age 12, Joondeph says. If this isn’t treated before permanent teeth come in, the bone and gums over the roots of extremely crowded teeth may become thin and recede and permanent teeth will become impacted. A space maintaineran orthodontic device with a fixed wiremay be placed between teeth to hold the place after a baby tooth comes out. An expansion appliance can be fixed to the back teeth to widen the upper jaw. Sometimes baby teeth may have to be extracted or the middle permanent molar removed to make room.

    These first-phase treatments may take a few months to a couple of years, depending on the severity of the problem.


  • Ages 10 to 14 – The most common time to put on braces is after all the permanent teeth have come in. But some children get braces as young as 8, and some aren’t ready until their late teens. Orthodontists take multiple X-rays, photographs and plaster models before fitting appliances or braces. Many create computer models to show patients how their teeth will move and what they will look like after treatment.

    Braces usually stay on for 12 to 18 months, depending on the orthodontic problems and the patients’ cooperation. A child will usually be in braces longer if he hasn’t had any first phase treatment.

Further Reading
For the latest braces news, check out our Complete Guide to Orthodontics.