Isn’t that the million-dollar question! According to the American Association of Orthodontists, all children should be seen for a consultation with an orthodontist by age 7 or 8. This is generally what is suggested, as this is the approximate age when the adult upper and lower incisor teeth are normally erupted.
At this time, approximately 12 baby teeth remain and 16 permanent teeth remain to erupt for the permanent dentition to be complete, not including wisdom teeth. While it is my view that most cases should be treated in a single comprehensive phase when all of the permanent teeth are erupted (around ages 11 to 14), there are some cases that could benefit from interceptive recommendations or an early treatment.
I am very conservative in recommending early treatment, since this sets up the case to be treated in two phases – which equates to more treatment and more costs. I only recommend early treatment if I am convinced that proceeding will make the second phase of treatment easier, better and more stable, for example avoiding the need for extractions or jaw surgery. Most of the cases that benefit from an early treatment phase are more severe malocclusions.
I support visiting an orthodontist at an early age, but I understand that there is skepticism about the profession and orthodontists starting treatment too early. At my office, I explain to parents that the benefit of bringing their child to me is that I will be able to provide a forecast for the future, whether or not treatment is recommended and when might be the right time to start.
More often than not, at my practice, young patients are placed on recall and monitored annually or biannually throughout their changing dentition until it is right to commence orthodontics, if at all. I offer all of these recall visits at no charge. My advice to parents who have received a recommendation for early treatment is to seek additional opinions if there is uncertainty about proceeding.
The types of things I recommend addressing early are: serious developing crowding of teeth; missing adult teeth; single tooth crossbites (an upper tooth that fits inside a lower tooth); crossbite relationships of multiple back teeth on one or both sides, anterior crossbites (an underbite); a short, under-developed lower jaw; thumb-sucking or tongue-thrusting habits; or severely protruding upper front teeth at risk of trauma. Early treatments make up about 15 per cent of my active patients, and I have hundreds of patients on recall.
Unlike the medical profession, where a referral is necessary to see a specialist, a referral to see an orthodontist (a dental specialist) is not necessary. Most parents are unaware that a referral by your general dentist is not required to see an orthodontist. Simply call to book an appointment at your convenience! Orthodontists are the only dental specialists who offer exams/consultations free of charge.
At my office, I view the exam appointment as the most important appointment a patient will have at my office. I provide a wealth of information and extend 30 minutes of one-on-one doctor time. Just because the exam is complimentary does not mean it should be perceived as low in value; in fact, it is quite the opposite.