The American Association of Orthodontists recommends that a child see an orthodontist by age 7, or sooner if you notice a problem. By then, most kids have a mix of baby and permanent teeth, which lets an orthodontist see how the teeth and jaws are developing. An early check is not the same as early treatment. Most 7-year-olds don’t need anything yet. The usual outcome is a baseline exam and periodic checkups while the permanent teeth come in. When a problem is developing that is easier to fix now, such as a crossbite or a narrow upper jaw, early treatment may help. At Greater Des Moines Orthodontics in Waukee, that first check is free.
Key Takeaways
- The AAO recommends a first orthodontic check by age 7, or earlier if something looks off.
- Most children that age don’t need treatment yet. Watching growth is often the right plan.
- Early treatment is for problems that get harder to fix later, like certain crossbites and crowding.
- You don’t need a referral from your dentist to schedule the visit.
Why do orthodontists want to see kids by age 7?
If your dentist mentioned crowding at your child’s last cleaning, or you’ve noticed the new front teeth coming in crooked, you’re probably wondering whether you need to do something now. Other parents worry about the opposite: starting braces on a second grader who doesn’t need them.
The reason age 7 works is what’s happening in the mouth at that point. Around that age, children have a mix of baby teeth and permanent teeth, and the AAO explains that this mix gives an orthodontist a lot of information about how the bite is developing. The first permanent molars are usually in. The front teeth are changing over. Problems with how the jaws fit together tend to show up here, sometimes before they’re obvious at home.
Age 7 is a deadline, not a starting line. If something looks wrong at 5 or 6, the AAO says not to wait. And if your child is already 9 or 10 and has never been checked, come in now. It’s not too late.
What happens at your child’s first orthodontic visit?
It starts with a conversation. You tell us what you’ve noticed or what your dentist said, and we ask a few questions. Does your child suck a thumb or finger? Do they breathe through their mouth a lot? Does chewing ever hurt?
Then Dr. Cameron Geyer or Dr. Austin Foster examines your child’s teeth and bite. For a 7-year-old, that mostly means opening wide, biting together a few times, and maybe sliding the jaw side to side. We’re counting teeth, checking which ones are loose or missing, and watching how the upper and lower teeth meet. There are no shots and nothing gets put on the teeth.
If treatment is recommended, we may take records such as photos, x-rays, or 3D scans. X-rays show what’s happening under the gums, including teeth that haven’t come in yet. The AAO notes that x-rays can reveal extra, missing, or impacted teeth that no one can see from the outside.
Then we tell you what we found, in plain language, with your child in the room. We explain to the child too, not just the parent, because a kid who understands why they’re getting an appliance takes better care of it, and that changes how treatment goes.
What is the orthodontist looking for?
We check tooth eruption, jaw development, crowding, and how the bite lines up. Most of what we find falls into a few groups.
Bite problems. A crossbite is when some upper teeth sit inside the lower teeth instead of outside them. Sometimes the jaw shifts to one side to make the teeth fit together. An underbite is when the lower front teeth sit ahead of the uppers. An open bite is when the front teeth don’t touch at all when the back teeth are closed.
Space problems. This means crowding that’s already significant, large gaps, or extra or missing permanent teeth.
Habits. A thumb, finger, or pacifier habit that has lasted long enough to affect the teeth or jaw growth is one of the problems the AAO lists as a possible reason for early treatment.
What signs can you watch for at home?
The AAO lists several warning signs parents can spot:
- Baby teeth falling out much earlier or later than usual
- Trouble chewing or biting, or chewing that hurts
- Breathing through the mouth most of the time
- A jaw that shifts or clicks
- Frequent cheek biting
- Teeth or jaws that look out of balance with the face
Any one of these is a reason to schedule a check, whatever your child’s age.
Why do most kids just need monitoring?
Most 7-year-olds we see don’t need treatment yet. The AAO describes three possible results from an early check. Treatment may never be needed. Treatment may be needed later, so the child is followed while they grow. Or there’s a developing problem that’s worth treating now. For many kids, it’s the middle one.
I think of monitoring like your pediatrician’s growth chart. One measurement doesn’t tell you much. The value is in the line it draws over time. At the first visit, we record where your child is. At periodic checkups after that, we see which way things are heading. Is the crowding getting worse or staying the same? Are the permanent teeth coming in on schedule? Is the jaw growing in a balanced way? Some things that catch a parent’s eye at 7 look different a year or two later, once more teeth are in. And if the line starts heading somewhere we don’t like, we catch it early and plan treatment for the right time.
That’s different from hoping a problem goes away. Real crowding doesn’t fix itself, and the AAO points out that the space for the permanent front teeth doesn’t grow as a child does. Waiting just means picking the right time to fix it, usually once more permanent teeth are in.
My own rule of thumb: treatment at 7 should solve a problem that would be harder to fix later. If it would only straighten teeth a few years sooner, I’d usually rather wait.
When does early treatment make sense?
Some problems are easier to correct while a child is still growing. In those cases, the AAO describes the goal as intercepting the problem, removing its cause where possible, guiding jaw growth, and making room for the permanent teeth. This is often called interceptive or Phase 1 treatment.
At our office, early treatment may include a palatal expander, limited braces, or removing certain baby teeth.
What is a palatal expander like?
A palatal expander is a small appliance that gently widens the upper jaw. It can help correct a crossbite, relieve crowding, and make room for teeth that haven’t come in yet. Many kids who benefit start somewhere around ages 7 to 10. In most cases, a parent turns the expander a small amount each day with a little key for about 2 to 4 weeks. Then it stays in place for about three months while new bone fills in, a bit like a cast holding a healing bone still. Expect the first few days to feel strange. Talking and eating take some getting used to, and many kids get a gap between their upper front teeth as the jaw widens.
What about limited braces or pulling baby teeth?
Limited braces go on just a few teeth to fix one specific problem, not the whole bite. And sometimes the most useful step is the simplest one: removing a baby tooth that’s in the way, at the right time, so the permanent tooth behind it can come in where it should.
One thing to know up front: early treatment doesn’t always replace braces later. The AAO notes that a second phase is sometimes still recommended once all the permanent teeth are in. What early treatment can do is make that later phase simpler, or deal with a problem that would be much harder to fix at 13. Before you start, ask whether a second phase is likely for your child.
What does an early check cost?
The first visit is a free consultation with no obligation to start anything.
If treatment is recommended, early interceptive treatment costs less than our most common comprehensive treatment fee of $6,750 before insurance benefits. The exact fee depends on the case, and our cost information page has the details. We offer interest-free financing with monthly payments, and our team will verify your orthodontic insurance benefits and file claims for you.
If your family has coverage through an Iowa state-sponsored plan, check the age rules. We accept Hawk-i for new patients of all ages. We accept Dental Wellness Plan (DWP) / Iowa Medicaid for new patients 11 and older. Iowa HHS now spells the program Hawki, but it’s the same program. Coverage for orthodontic treatment depends on each plan’s rules, and our team can help you sort out what applies to your child.
How does our practice handle early checks?
At our office on Hickman Road in Waukee, many early checks end with a plan to come back for another look, not a plan for treatment. Every early check is done by one of our two board-certified orthodontists. Dr. Foster grew up in the Des Moines area and graduated from Waukee High School. Dr. Geyer and Dr. Foster both trained in the University of Iowa orthodontic residency program. If your child does need something now, we’ll explain why now matters and what happens if you wait. Our early orthodontics page has more on how we approach these years.
FAQ
Do I need a referral from our dentist?
No. The AAO says you don’t need to wait for a dentist referral, and you can call us directly. If your dentist has referred you, bring along whatever they gave you.
My child is only 5, but their bite looks off. Should I wait?
No. Age 7 is the latest recommended age for a first check, not the earliest. If you notice a crossbite, a jaw that shifts, or anything that seems wrong, schedule a visit now.
Will my child need braces later even if they have early treatment?
Sometimes, yes. Early treatment handles a specific developing problem. A second phase may still be recommended once the permanent teeth are in, so ask at the start whether one is likely in your child’s case.
What if we’re told to wait? Does that mean nothing is wrong?
Not necessarily. It means nothing needs treatment right now. We’ll keep checking your child periodically as they grow, and we’ll recommend treatment if and when it will actually help.
If your child is 7 or older and hasn’t had an orthodontic check, or if something about their bite has you wondering, schedule a free consultation or call (515) 285-6029. We’ll take a look and tell you whether it’s time to act or time to watch.
This article is general information, not a diagnosis. Your child’s needs depend on an exam by an orthodontist.