When Should My Child Get Their First Orthodontic Evaluation?
As parents, we’re used to keeping track of growth milestones—first steps, first words, the first day of school. But there’s one important “first” that often catches families by surprise: a child’s first orthodontic evaluation. Contrary to what many people assume, orthodontics isn’t just for teenagers with braces. In fact, evaluating your child’s bite and jaw alignment early on can prevent bigger problems down the road.
So, when exactly should your child see an orthodontist for the first time? Let’s break it down.
The Ideal Age: Age 7
According to the American Association of Orthodontists (AAO), children should have their first orthodontic evaluation **by age 7**. That doesn’t mean your child will need braces right away—in fact, most won’t. But at this age, a mix of baby and adult teeth are present, which gives orthodontists a clear view of how the jaws are developing and how the permanent teeth are coming in.
Early evaluation allows the orthodontist to detect subtle problems that may not be obvious to parents or even general dentists. And in many cases, the best treatment plan is simply to monitor growth and development until the time is right.
Why age 7? What makes this stage so important?
By age 7, several key dental and skeletal milestones have occurred:
– The first adult molars have usually erupted, helping to establish the permanent bite.
– The front adult teeth are coming in, and their position can indicate crowding, spacing, or bite issues.
– The jaws are still growing, which means that problems like crossbites, underbites, or narrow arches can be more easily corrected while bones are still developing.
Catching issues early doesn’t always mean treatment will start immediately, but it gives your child the best chance at a healthy, functional smile—often with less complexity and expense than if you wait until the teen years.
Signs Your Child Might Benefit from an Early Orthodontic Evaluation
While age 7 is the ideal time for a first orthodontic check, some children may show signs that they need to be seen even earlier. As a parent, it’s important to watch for subtle clues that your child’s bite, jaw development, or tooth alignment might not be progressing as expected. These signs don’t always mean your child will need immediate treatment—but they do indicate that a professional evaluation could be helpful.
Let’s take a closer look at what to watch for:
1. Early or late loss of baby teeth
Most children begin losing their baby teeth around age 6. If your child starts losing teeth significantly earlier—or if the baby teeth are still firmly in place well after age 7 or 8—it could signal an issue with the way the adult teeth are developing or erupting. Early loss may cause nearby teeth to drift and crowd the space for future teeth, while delayed loss could mean the adult teeth are impacted or misaligned.
2. Difficulty chewing or biting
If your child frequently struggles to bite into food, chews only on one side, or complains that chewing feels uncomfortable, it could be due to a misaligned bite. Improper tooth contact can make chewing inefficient or even painful, and may lead to digestive or nutritional issues over time.
3. Mouth breathing
Breathing through the mouth instead of the nose—especially during sleep—can affect jaw and facial development. Chronic mouth breathing is often linked to narrow upper arches or high palates and may be a sign that the airway needs to be evaluated. Orthodontic intervention can sometimes help guide better oral posture and growth.
4. Thumb sucking or finger sucking beyond age 4
While thumb sucking is a common self-soothing habit in babies and toddlers, prolonged sucking beyond preschool age can begin to affect the shape of the jaw and the position of the front teeth. It can lead to an open bite (where the front teeth don’t touch when biting) or protrusion of the upper teeth, both of which may require orthodontic correction.
5. Speech difficulties
A misaligned bite, narrow jaw, or abnormal tongue posture can sometimes interfere with proper speech development. If your child struggles with certain sounds, has a lisp, or seems delayed in speech clarity, an orthodontic assessment may help identify whether the structure of the mouth is contributing to the issue.
6. Crowded, crooked, or overlapping teeth
Visible crowding, overlapping, or teeth coming in at odd angles are signs that there may not be enough room in the jaw to accommodate all the adult teeth. Addressing this early may help reduce the need for extractions or lengthy treatment later.
7. Jaw shifting, popping, or asymmetry
If your child’s jaw visibly shifts when they open and close their mouth—or if you notice clicking, popping, or favoring one side—this may indicate problems with how the jaws are growing or aligning. In some cases, early treatment can guide the jaws into a more balanced relationship before they become fixed in a misaligned position.
8. Protruding front teeth
Teeth that stick out—especially the upper front teeth—are not only more vulnerable to injury (such as fractures from a fall) but also can be a source of self-consciousness for children. Early orthodontic care may help bring the teeth into a safer, more aesthetically balanced position while the jaw is still developing.
9. Biting the cheek or roof of the mouth
If your child frequently bites their cheek or complains about soreness on the roof of their mouth, this could be a result of teeth that aren’t properly aligned. This kind of misalignment can lead to tissue irritation and may be a sign of a crossbite or other bite issue.
10. Teeth that don’t meet properly (overbite, underbite, crossbite, or open bite)
These types of bite discrepancies may not be easy to spot without a professional evaluation, but some signs—such as difficulty closing the mouth completely, teeth not touching in the front, or the lower jaw sticking out—can point to more complex alignment problems that benefit from early correction.
Even if your child’s teeth look relatively straight, it’s important to remember that orthodontic problems aren’t always visible on the surface. An orthodontist can spot early warning signs in jaw development or bite function that aren’t obvious to the untrained eye.
Getting ahead of these issues doesn’t necessarily mean starting braces right away—but it does mean creating a roadmap that supports your child’s healthy growth and gives their future smile the best possible start.
What Happens During the First Orthodontic Visit?
The initial evaluation is gentle and informative. It usually includes:
– A visual exam of your child’s teeth and jaw alignment
– X-rays or digital scans to assess tooth positioning and bone growth
– A discussion about your child’s oral habits (e.g., thumb sucking, mouth breathing)
– An assessment of whether treatment is needed now, later, or not at all
Most early visits end with reassurance and a plan to check back periodically. In some cases, early intervention (called Phase I orthodontics) may be recommended to guide jaw growth, create space for erupting teeth, or address habits affecting oral development.
Benefits of Early Orthodontic Evaluation
Having your child’s orthodontic development evaluated around age 7 might seem early, especially if their teeth appear straight. However, there are several long-term advantages to spotting and addressing issues at this early stage—before the jaws and face finish growing. Early evaluations allow orthodontists to take a proactive approach rather than waiting for problems to fully develop.
Here are the key benefits of an early orthodontic assessment, explained in greater detail:
1. Guides proper jaw growth
The bones of a child’s face and jaws are still soft and growing. If one jaw is growing too fast or too slowly compared to the other, or if the upper and lower jaws aren’t aligned properly, early orthodontic intervention can help gently direct jaw development. For example, with a crossbite or underbite, an orthodontist can use appliances to encourage symmetrical growth and avoid skeletal imbalances that would be harder to correct later.
2. Reduces the risk of trauma to protruding teeth
Children with prominent upper front teeth (often due to an overjet) are more likely to injure them during sports, play, or falls. These teeth are often less protected by the lips and more vulnerable to being chipped or knocked out. Early orthodontic treatment can help reposition the teeth to a safer angle, reducing the risk of dental trauma.
3. Improves appearance and self-esteem
Even at a young age, children can become self-conscious about how their smile looks—especially if they have severely crooked or protruding teeth. Addressing visible orthodontic concerns early on can help boost your child’s confidence and make them more comfortable speaking, smiling, and interacting socially during critical developmental years.
4. Creates space for crowded or erupting teeth
Sometimes, baby teeth don’t leave enough room for the permanent teeth to come in correctly. This leads to crowding, overlapping, or even impacted teeth. With early treatment, an orthodontist may use space maintainers or arch expanders to help make room for incoming adult teeth, reducing the chance they’ll come in misaligned or need to be extracted later.
5. Reduces the need for tooth extractions later
When crowding or alignment issues are managed early—especially with appliances that guide growth or create space—it’s often possible to avoid the need for removing healthy permanent teeth later just to “make room.” Preserving natural teeth is always the preferred goal whenever possible, and early intervention makes that more likely.
6. May shorten and simplify future orthodontic treatment
One of the most overlooked benefits of early orthodontic care is that it can often simplify or shorten the comprehensive treatment that may be needed during adolescence. By addressing foundational issues early, orthodontists can reduce the time your child spends in braces or aligners later—and sometimes avoid the need for full treatment altogether.
Final Thoughts
Think of an orthodontic evaluation like a well-child checkup—but for your child’s bite. By age 7, most children are ready for a quick, non-invasive assessment that could make a big difference in their oral health journey. Early monitoring doesn’t mean early braces—but it does mean smarter planning and healthier outcomes.
Your child’s smile is developing more quickly than you think. With a timely orthodontic evaluation, you can help ensure it grows into the confident, healthy grin they deserve.
