Orthodontic Patient

A Child’s First Orthodontic Exam Should Be Completed By Age Seven

By Dr. Christopher Cosse

Parents often ask, “When is the right time to take my child to an orthodontist?” and “Do I need a dentist’s recommendation or referral to see an orthodontist?” Even after 20 years of working as an orthodontist, I still get these starter questions – and still, patients are often surprised by the answers that I give them.

The American Association of Orthodontists recommends a child’s first checkup with an orthodontist be performed by age seven, or earlier if an orthodontic problem seems to be present.* Why age seven? Although many parents believe they should wait until a child’s baby teeth are gone and all permanent teeth are in, that is the opposite of what orthodontists recommend.

Like most things in life, timing is everything. That is true in orthodontics as well. Early treatment, also known as interceptive treatment, is treatment performed while some baby teeth are still present. The goal of an early visit is to detect and be able to treat a potential developing problem, help eliminate the cause, guide the growth of facial and jaw bones, and be able to assist in creating adequate space for incoming permanent teeth before they all move into place. Age seven is the right age to still have some baby teeth and have some permanent teeth as well.

What A Child’s First Visit To The Orthodontist Might Look Like

In my office, a first appointment usually includes a thorough examination of the mouth, teeth, and bite and a study using dental tools such as X-rays, models of teeth or photographs. From this review, an orthodontist will develop a custom treatment plan if treatment is needed.

Outcome Of A Child’s First Orthodontic Exam

An early orthodontic exam doesn’t mean your child is immediately getting braces or some other orthodontic treatment. The outcome of an initial checkup at around age seven includes three primary outcomes:

  • No immediate treatment is necessary
  • Treatment may be needed in the future, so we will want to follow the child while his or her face and jaws grow
  • There is a problem detected where early treatment is important

What Teeth Straightening Problems Can An Orthodontist Treat While A Child Is Still Young?

While a child still has some baby teeth, an orthodontist may recommend treating:

  • Excessively spaced teeth
  • Extra or missing teeth
  • Underbite – when the lower front teeth are in front of the upper front teeth
  • Crossbite – when the jaw is shifted to one side and does not enable a straight bite, where the top and bottom teeth do not bite in an optimal position
  • Overcrowded teeth
  • Teeth that meet abnormally or not at all (malocclusion)
  • Teeth that have shifted due to thumb, finger or pacifier sucking
  • Problems due to an accident
  • Genetic abnormality

What Does Early Orthodontic Treatment For Children Look Like?

Early orthodontic treatment can take several forms. The orthodontist could prescribe a removable or fixed “appliance.” This is a device used to move teeth, hold teeth in place in an effort to create a desirable change, or change the position of the jaw. Sometimes, removal of some baby teeth may help the permanent teeth erupt better. These will be timed around the patient’s growth and development.

The goal of an early orthodontic exam is to assess your child’s situation. Some orthodontic problems may be easier to correct if they are identified and treated early. Correction may become more difficult once permanent teeth come in and facial growth nears completion.

Many parents think orthodontists create beautiful smiles – and they do! But the truth is much deeper than just aesthetic beauty. Proper oral health helps impact overall health. Orthodontists have years of training specifically in the complex biological movement of teeth and jaws, and we understand how to create proper functioning teeth and jaws…

In My Practice

Over the years, I have seen many patient cases where I wished I had had the opportunity to see the patient sooner because I believe there could have been a better or easier outcome if I had. A few examples of this would include the extraction of permanent teeth due to overcrowding, as well as oral surgery, both of which may have been avoided had they come in at an earlier time.

Do I Need A Dentist Referral For My Child To See An Orthodontist?

Oftentimes, a child’s dentist will see problems and recommend seeing an orthodontist. Other times they do not. But you do not need to have a referral to see an orthodontist. You can make an appointment directly. You should do your research to find an orthodontist who is highly recommended in your area by other parents you know, or who has high patient satisfaction ratings online. You can also find an orthodontist for braces in your area here or start the process for treatment with clear aligners here.

Remember, timing is everything. Make an appointment by the time your child hits second grade or as soon as you detect a problem.

About the Author

A native of Louisiana, Dr. Cosse graduated from Louisiana State University-Baton Rouge and from the dental program at Louisiana State University School of New Orleans (LSUSD). He received certification in Orthodontics and Dentofacial Orthopedics from Oregon Health Sciences University in Portland, Oregon. He studied the differences in orthodontics and prosthodontics between the United States and Europe for a term at the University of Freiburg, Germany in 1997. Dr. Cosse was awarded the Pierre Fauchard Award for Academic Achievement white at LSUSD.

Since joining his father’s practice in 2000, he has strived to further his orthodontics knowledge and training. He continues to drive progress in the field of orthodontics in many ways. In 2004, Dr. Cosse was invited to join in an international group of experts called The Insiders. In 2008, he was chosen to join an honorary task force of orthodontists called the Pathfinders.

He has several orthodontic patents and apps to his name and has been asked to speak at multiple conference both in the United States and abroad.

When he is not having fun at work, Dr. Cosse enjoys spending time with his wife, Stacy, and their children, Athan, Michael, Kali, and Stefan.

Dr. Cosse founded Braces Academy™ over six years ago with the idea of a cloud-based software that would help doctors by allowing them to use the power of Prescriptive Patient Education™ to send videos & elastic images directly to patients.

Three years ago, he founded OrthoScreening™ which has performed tremendously so far by offering a virtual consult platform for patients to connect with doctors outside of the practice.

*American Association of Orthodontists, https://www.aaoinfo.org/system/files/media/documents/Right_Time_for_Ortho-MLMS-hl.pdf

The opinion’s expressed are those of Dr. Cosse. Individuals should seek the advice of an orthodontist. Individual results may vary.

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