When do kids need to start braces?

The American Academy of Orthodontics recommend all children to have an orthodontic screening by the age six.  Typically, this is done by the child’s pediatric dentist.  Most children who have normal skeletal relations (how the upper maxilla and the lower mandible come together) don’t need to start orthodontic treatment until they have all their permanent teeth, usually around the age of 12 or 13.  The most common problem that orthodontia treats is crowding, which simply means that the jaw bone is too small to accommodate all the teeth resulting in crooked and overlapped teeth.

Mild Crowding

Unfortunately, some children do have abnormal bone structure and need earlier intervention.  Sometimes the upper maxilla can be too small and the lower mandible too large, resulting in what we call a “cross-bite“, which is also known as  an “under-bite”.  Other times crowding can be so severe that new permanent teeth are unable to come in, gum recession can start to develop, or kids become self conscious from getting teased in school.


Anterior Crossbite (Underbite)


Severe Crowding


For these more complicated problems, orthodontic treatment is recommended at an earlier age, typically around age 7 or 8.  There are various retainers and appliances that an orthodontist can place that will relieve various skeletal problems.  These early treatments are called Phase I treatment.  Later on, if the child still needs conventional braces, the latter treatment is referred to as Phase II treatment.  Phase I treatment not only relieves immediate concerns, it also makes Phase II treatment much simpler and shorter in duration.


Phase I Palatal Expander to relief posterior crossbite

Phase I Hawley Appliance to relieve Anterior Crossbite


In my Las Vegas pediatric dental office, I perform an orthodontic screening  every time a patient comes in for a six months cleaning/check-up appointment.  If a major skeletal problems is detected, a referral is made right the way for a orthodontic consultation.  Most patients don’t need to go until they have lost all their baby teeth.

If you have any questions regarding orthodontic screening, please feel free to contact me in my Las Vegas pediatric dental office.