Why are children starting orthodontics so young?

When I grew up, braces were common in middle school and high school, but not elementary school. The general thought process back then was to see the orthodontist for the first time when all of the baby teeth fell out, which is typically around 11-14 years old. 

The American Association of Orthodontists has always recommended that patients see the orthodontist for the first time at 7 years old. However, twenty or thirty years ago, social media did not exist for this message to spread. Parents were not aware of this recommendation, so almost everybody waited until teenager years before scheduling an initial orthodontic consultation. 

When a child presents to an orthodontist at 7-9 years old, growth potential remains enormous. If a problem is present at this young  age, an orthodontist is able to intervene with excellent and predictable success. This sets the path for easier orthodontic treatment down the road.

When a teenager presents for the first time to an orthodontist, a lot of the patient’s growth is already in the past. As a result, orthodontic treatment options may be limited. For example, in challenging situations like severe dental crowding, an orthodontist may even recommend extractions. Two or three decades ago, extractions of teeth for orthodontic purposes was actually quite common for this very reason.

I personally am not a believer in extraction of adult teeth for orthodontic purposes. I am a “non-extractionist”, where I will do everything possible to avoid teeth being removed. One of the most important parts of my philosophy though is an orthodontic consultation at a young age to check if any intervention is indicated. With that being said, the vast majority of patients in my practice still do not need any early orthodontic treatment. Instead, in over 80% of patients, my recommendation is to delay orthodontics until all of the baby teeth have fallen out.

In a small percentage of patients, certain situations do call for early orthodontics during elementary school. In these select cases, starting early is integral for long term success.