Do My Children Need to Wait Until They Have All Their Permanent Teeth to See an Orthodontist?

Expert Contribution by Dr. Barbara Fodero, Chatham Orthodontics

Barbara Fodero, DDS, MS

If someone tells you that your child should have all of his/ her permanent teeth before visiting the orthodontist for the first time, think again. Putting off a first visit to the orthodontist until all of a child’s permanent teeth are in could do more harm than good. Here’s why:

There’s a lot more going on than meets the eye. A child’s mouth is undergoing a lot of change. Beginning at the age of 6, an exchange of teeth begins as baby teeth fall out and are replaced by larger-sized permanent teeth. And it all happens in a predictable order. Unless it doesn’t.

The baby teeth and gums hide the developing permanent teeth below and can mask conditions that interfere with the emergence of these teeth. Parents can watch for clues. Early or late loss of baby teeth can signal a problem. So can trouble with chewing or biting, thumb-sucking or tongue thrusting and mouth-breathing. If these indicators are not addressed until a child has all of his/her permanent teeth and growth is essentially complete, correcting the problem may be more difficult than it might have been had treatment occurred earlier.

Orthodontic treatment is about creating a healthy bite—the beautiful smile is a bonus. The goal is to make sure the bite is right and that the upper and lower teeth fit together like interlocking gears.

Some children can wait until they have all or most of their permanent teeth. Other children’s orthodontic problems may be better treated while some baby teeth are present. These children require growth guidance of bones in the upper and lower jaws, so there’s enough room for permanent teeth.

Their treatment can be timed to predictable stages of dental development and physical growth.

Dentists and orthodontists look at the mouth differently. Dentists assess and promote overall oral health. With a focus of detecting cavities and gum disease, they take “bite wing” x-rays to isolate a particular section of teeth as part of their diagnosis. Orthodontists are laser-focused on each patient’s bite. Orthodontists use “panoramic” x-rays to visualize all of the teeth above and below the gums to check for missing or impacted teeth and teeth coming in at the wrong direction.

If your dentist has not referred your child to an orthodontist, you need not wait for a referral. Orthodontists do not require a referral for you child to be seen. The American Association of Orthodontists recommends that children have their first visit with an orthodontist no later than age 7. If a problem is detected and treatment is advised, you are giving the orthodontist the opportunity to provide your child with the most appropriate treatment at the most appropriate time.

33 Main St, Chatham, NJ 973-701-2200 • www.chathambraces.com

Barbara Fodero, DDS, MS