Orthodontic associations recommend that children have an orthodontic check with a dentist or orthodontist at around age 7, when the first permanent teeth have come through and jaw growth and the bite can be assessed. Most children need no treatment at this age, only monitoring. But some problems, such as a crossbite, harmful habits or losing a baby tooth early, are simpler to treat while the child is still growing than after growth has finished.
By this age the first permanent molars and front incisors have come through or are starting to, and the dentist can see how the jaws relate and whether crowding or a bite problem is likely. An early check does not mean early braces; it means choosing the right timing.
In most cases the decision is to monitor from time to time until the permanent teeth are through, then start orthodontic treatment if needed in early adolescence. The few cases that need early treatment are planned carefully.
Watch for these signs in your child; having them does not necessarily mean treatment is needed:
For some problems the child's growth can be used to advantage; their treatment is called interceptive orthodontics, or phase one:
Thumb-sucking and dummy use are normal in the early years, but continuing once the permanent front teeth arrive can push them forward and cause an open bite or a narrow upper jaw. The best start is encouragement and rewards, not punishment, and your dentist may suggest a simple reminder appliance if the habit continues.
Constant mouth breathing may be caused by a blocked nose, such as nasal allergies that can flare with dust, or enlarged adenoids and tonsils. It can affect jaw growth and tooth position, so your dentist may refer you to an ear, nose and throat specialist to assess the cause.
If a back baby tooth is removed early because of decay, the neighbouring teeth can drift into the gap, leaving too little room for the permanent tooth when it arrives and causing crowding or impaction. A space maintainer, a small fixed or removable appliance, holds the space until the permanent tooth comes through.
This is why treating decay in baby teeth and keeping them until they fall out naturally is an important part of preventing orthodontic problems later.
No, they are usually a good sign, as they leave room for the larger permanent teeth. A gap between the upper permanent front teeth at around age 8 to 9 is also common and often closes as the canines come through.
Not always. Early treatment corrects certain problems or makes them less severe, and some children still need a second phase of treatment after the permanent teeth are through, though it is usually simpler.
Your child may feel pressure or mild soreness for a few days after an appliance is fitted or adjusted, which eases gradually. Soft foods help in those days, and your dentist will advise what suits your child.
Treatment can start at any time, but some families prefer to begin during the holidays so the first days are easier for the child. Follow-up visits are usually every few weeks and can often be arranged after school.
Book a check for your child at around age 7, and sooner if you notice a crossbite, the jaw shifting when the teeth close, very prominent front teeth, constant mouth breathing, thumb-sucking continuing after the permanent teeth appear, or early loss of a baby tooth. If your child knocks their front teeth, see a dentist the same day. You can book an appointment at Medical Care Clinics in Al-Shati Al-Gharbi, Dammam, close to Al-Khobar and Dhahran, where our dental team will assess how your child's teeth and jaws are developing and explain whether treatment is needed now or monitoring is enough.
This article is general health education and does not replace a medical examination. Every case needs its own assessment by a doctor.
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