When Should I Pursue Orthodontic Treatment (Braces) for My Child?

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When to Begin Orthodontic Treatment 

It is important to first understand that there are a variety of equally well-founded, professional opinions regarding when orthodontic treatment should begin.  Nonetheless, as a general rule of thumb, braces are typically not placed until the pediatric patient has:

1) Lost all their primary (or baby) teeth; and

2) The second molars, which typically erupt at around 12 years old, are at least partially visible in the mouth.


Exceptions to the general timeline above do exist in some cases.  Some examples in which treatment start dates may either be delayed or begun earlier than anticipated include:

1)  Cases Where Severe Malocclusion May Delay Onset of Treatment

Taken from the latin root words ‘mal’, meaning wrong or improper, and ‘occludere’, meaning to close or shut, malocclusion in dentistry refers to an incorrect positioning or alignment of the teeth as they come together in closure.  There are several causes of malocclusion, but common causes include dental crowding, overbite, tooth impaction, and missing or extra teeth.  In cases of severe malocclusion, patients often require additional time before the placement of braces.  In these cases, a common reason for a delayed start time is due to the necessity of waiting for the eruption of impacted permanent teeth.

Another cause for delay of treatment is in cases where an underbite exists.  Children that display these types of bites often continue jaw growth until the age of 16 or 18 years of age.  As such, waiting until that growth has completed (to avoid an unnecessarily long treatment time) is most often the better rule of thumb.

2) Cases Where Severe Malocclusion May Accelerate Onset of Treatment

In some cases, a malocclusion can be severe enough to cause social anxiety for a patient.  Children who are being made fun of at school because of the way they look may in some cases provide justification for an earlier onset of orthodontic treatment.

Another case justifying earlier treatment of orthodontics is when harm to the teeth or a normal course of development may be otherwise prevented.  In these severe malocclusion cases, where the likelihood of injury or incorrect development of permanent teeth is particularly high, earlier intervention may be recommended.

In conclusion

Though there are general guidelines, it should now be understood that the best start time for orthodontic care is on a case-by-case basis.  Therefore, if you have any unaddressed questions regarding when to best begin orthodontic treatment for your child, feel free to ask your Dr. Ruelf at the time of your next appointment.

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