At what age should I take my child to the orthodontist?
I prefer to see kids for the first time when they are about 8 or 9 years old because typically at that age, I’m able to diagnose problems that require intervention early, in what orthodontists call Phase I treatment. My next blog post will discuss some indications for Phase I treatment but let me explain a little more about what is happening at age 8-9.
As I’ve mentioned before, I practiced general dentistry for 5 years before studying to become an orthodontist. What I learned in my orthodontic training is that orthodontists are experts in the dental field at growth and development. In my training as a general dentist, I learned the progression of teeth from primary, or baby, teeth to permanent teeth. Beyond that, I held little knowledge on exactly how and when the head and neck grew and developed from embryonic stage to adulthood.
What I learned in my orthodontic residency is that children can exhibit different “ages.” One age is the chronologic age, or how old the child actually is in terms of years, months, and days. Another age is the dental age, which is estimated based on what teeth are present in the mouth. And, finally, another age is skeletal age, or the body age. The skeletal age is related to whether or not the child has undergone puberty; where they are in terms of growth potential. In the “average” child (whatever that is!) the chronologic age, the dental age, and the skeletal age are somewhat congruent.
As examples, the “average” 8 year old has 4 permanent front teeth in both the upper and lower jaw. As you move backwards in their mouth, there are 3 baby teeth in each quadrant, and then, behind those baby teeth, are the permanent 6 year molars. The remaining adult teeth, if present, can usually be visualized with x-ray. Furthermore the “average” 8 year old has ample growth potential, barring any syndrome that may inhibit skeletal growth.
However, a recent patient will demonstrate how these different ages can be different. This patient just celebrated her 11th birthday, but she has the arrangement of teeth of a 9 year old (similar to what I described in the previous example). Skeletally, she’s already passed menarche, meaning that she is past her peak growth, and has the body of a 14 year old.
The reasons I like to see children at age 8-9 is because:
Most 8-9 year olds have ample growth remaining. So, any problem where I can harness normal growth and development to fix it can be addressed long before growth ends.
Most 8-9 year olds have the arrangement of teeth that I described previously. At that stage, where there are 4 permanent incisors in both the upper and lower teeth, I can diagnose most orthodontic problems.
In the likely event that no treatment is required at that time, we are able to give kids a positive experience that should let them be more comfortable with orthodontic treatment in the future.
And, the best part, orthodontic consults are free!