The Recommendation Behind the Age 7 Visit
The Canadian Association of Orthodontists recommends that every child have their first orthodontic evaluation by age 7. That recommendation is not about starting treatment early. It is about screening your child’s bite and jaw development for issues that are urgent and are more easily corrected at a young age.
By around age 7, most children have their first permanent molars in, along with their permanent front teeth. We can see how the upper and lower jaws are lining up, whether there is enough room for the rest of the permanent teeth to come in, and whether the jaws themselves are growing in a way that is balanced.
If you wait until all the permanent teeth have erupted in the young teen years, much of the jaws’ growth is finished, which makes it much more difficult to treat.
A Screening Is Not the Same as Treatment
Seeing an orthodontist at 7 does not mean your child is getting braces at 7. In most cases, what we recommend after that first visit is simply monitoring, with a plan to check back in as your child continues to grow.
Only when we identify a specific issue, one where waiting would make it more difficult to correct in the future, do we talk about early treatment. About 15% of children need early treatment to correct issues that are more easily corrected at a younger age.
Why Some Children Come In Even Earlier
As the orthodontist on the Cleft Lip and Palate Team at Saint John Regional Hospital, I also see children well before age 7 when a craniofacial condition calls for it. Sometimes your family doctor or an ENT specialist may recognize mouth breathing and may recommend early palatal expansion. If your pediatrician, family doctor, or dentist has raised a concern along those lines, please do not wait for age 7. We are glad to see your child sooner. Learn more about mouth breathing and sleep apnea here.
What We’re Specifically Looking For
Parents sometimes assume an orthodontic evaluation is just a more detailed version of what their dentist already checks. It is related, but the focus is different. A dentist’s exam is largely about the health of the teeth and gums themselves, cavities and hygiene. An orthodontic evaluation is about how the teeth, jaws, and bite are developing in relation to each other over time.
At a first visit, we are typically looking at: whether the upper and lower jaws are growing in proportion to one another, whether there is enough space for the permanent teeth still on their way, whether the bite closes the way it should, and whether any habits, like prolonged thumb sucking or mouth breathing, are actively shaping how the mouth is developing. None of this requires your child to have any permanent teeth in a final position. It is precisely because so much is still in motion at age 7 that this window is so useful.
Why This Isn’t Just About Straight Teeth
A lot of the hesitation I hear from parents comes from thinking of orthodontics purely in terms of appearance, as though we are only evaluating the esthetics of the smile. The things we are look for in this screening are more structural and functional, such as how the jaw growth and bite alignment affect chewing, speech, breathing, and even the health of the permanent teeth as they come in. A crossbite left unaddressed, for example, can cause a jaw to grow asymmetrically over time, which becomes a much larger issue to correct in the teenage years than it would have been at age 7. Learn more about early orthodontic treatment here.
So while a straight, confident smile is certainly part of what we are working toward in the future, the reason we start looking at age 7 has much more to do with function and healthy development than with cosmetics.
What We are Watching For
- Position of the upper and lower jaw relative to each other (eg. overbite or underbite)
- Width of the upper jaw and size and shape of the palate (eg. a narrow palate)
- Open mouth posture or tongue sitting between the teeth
- History of thumb sucking or prolonged pacifier use
- Jaw asymmetry especially when opening or closing the mouth
- Severe crowding or spacing of the teeth
- Crossbite of the teeth (upper teeth sitting behind the lower teeth)
- Deep bite or open bite (front teeth not overlapping properly)
- Missing teeth or impacted teeth (teeth that are stuck in the jaw)
- Severe protrusion of the teeth
- Speech difficulties
- Gum recession, gingivitis
Learn more about the orthodontic issues we treat at MacKenzie Orthodontics by following this link.
What Your Child’s First Visit Includes
Every first visit with us is a free consultation, and it is fun and thorough. We take digital x-rays, clinical photos, a 3D intraoral scan, and build a personalized smile simulation, so we have a complete picture of the tooth and jaw development. At the screening consultation, I will discuss with you if any early treatment is needed or if your child can be monitored until all their adult teeth come in.
A Typical First Visit, in Practice
The first visit at age 7 is a fun way to meet our orthodontic team. There are no needles, no freezing and no “drilling”, it is a super friendly way to introduce your child to the world of orthodontics. We will take photos of your child’s face and teeth, x-rays of the teeth and jaws, and a 3D scan with a cool laser wand. I will show you everything and explain, in easy to understand language, what is going on with the teeth and bite, and what to expect in the future. Most children do not need treatment at this age and I recommend re-evaluating annually. These evaluation (or “growth and development”) visits are free of charge and also very fun. Learn more about our growth monitoring program here.
Patients who need early treatment are not necessarily ready at age 7. Sometimes if there is a narrow palate or mouth breathing, or a risk of impacted teeth, we watch until the child and family are ready for treatment. Orthodontic treatment needs to fit in your family’s routine, because we are treating a person, not just a set of teeth. The value of the screening visit is not that something always needs fixing. It is that a trained eye is now keeping track of your child’s development at exactly the age when it matters most.