Many parents assume they must wait until their child has all of his or her permanent teeth to see Dr. MacKenzie for an orthodontic consultation. However, in many cases, treatment would have been much easier if started earlier.
So why age 7? At this age the permanent molars have erupted and allowing us to check for malocclusion or “bad bite” such as an overbite or an underbite. Also, all the permanent incisors have erupted and Dr. MacKenzie can evaluate if there is crowding, deep bites and open bites. The orthodontist can see all the permanent teeth on a panoramic x-ray allowing her to diagnose missing teeth or malaligned teeth even before they come in. Additionally, Dr. MacKenzie can determine the growth pattern of the upper and lower jaws and diagnose a jaw overbite or a jaw underbite.
Orthodontic evaluation at age seven does not actually mean that orthodontic treatment will start at this age. At the complimentary initial consultation, will review the clinical exam, photos and x-rays with the patient and the parents. Most of the patients at MacKenzie Orthodontics are not treated at age seven and instead continue to be evaluated by the orthodontists every 6-12 months to make sure that the permanent teeth are erupting properly and the upper and lower jaws are growing proportionately. These “growth and development checks” are also complimentary.
For some patients, early correction of problems leads to easier and shorter orthodontic treatment in the future. Problems such as crossbites, underbites, and asymmetrical shifts of the lower jaw are easier to correct at a younger age and their treatment prevents further problems later on. For some children, early treatment can prevent tooth injury and can allow for good oral hygiene due to improved tooth alignment. Early treatment is meant to correct “urgent” orthodontic problems before they become difficult to manage. Most early treatment nowadays is done with Invisalign First: an Invisalign treatment option specifically designed for children.
So, if your child is nearing his or her seventh birthday, give us a call at MacKenzie Orthodontics to schedule a complimentary consultation.
What Is Phase 1 (Early) Treatment?
Phase 1 treatment is orthodontic care started while a child still has a mix of baby and permanent teeth, generally between ages 7 and 10. It does not address every crooked tooth. Instead, it targets specific, urgent problems while the jaw is still growing and easiest to influence, including:
- Guiding jaw growth and correcting a narrow upper arch
- Correcting crossbites, underbites, or severe overbites
- Creating room for crowded permanent teeth to erupt properly
- Correcting asymmetrical shifts of the lower jaw
- Reducing the risk of tooth injury caused by protruding front teeth
For some children, treating these problems early leads to a shorter, simpler course of treatment later on and can reduce the likelihood of needing extractions. Dr. MacKenzie has treated over 2,000 children with Phase 1 treatment and palatal expanders, and will always explain clearly whether your child’s case would benefit from starting now or is better served by continued monitoring.
Two Modern Ways We Expand a Child’s Smile
For children who need palatal expansion as part of Phase 1 treatment, we offer two advanced, comfortable options in addition to a traditional expander, and Dr. MacKenzie will recommend the one best suited to your child’s specific case.
Invisalign Palatal Expander
For children who need a significant amount of expansion, the Invisalign Palatal Expander offers the same skeletal expansion as a traditional rapid palatal expander, without the key or the screw. It is worn full time, even at meals, which means it cannot be lost or forgotten the way a removable appliance can, and it is far easier to keep clean than a fixed appliance. This option is considered when significant, skeletal expansion is the primary treatment goal.
Angel Kid Aligner System
For children with mild to moderate expansion needs, the Angel Kid Aligner System is a removable option that looks just like a regular clear aligner but is designed specifically to be used with baby teeth in a growing child. It supports healthy arch development, requires the fewest office visits of any option we offer, and is the most comfortable choice for most kids. Angel Kid is a great fit for children who need dental arch development or have noticeable crowding or tooth protrusion, and it is also the best option for children who play a wind instrument, since it comes out at practice time.
Invisalign First: Full Aligner Treatment for Growing Smiles
For children whose Phase 1 needs go beyond expansion alone, most early treatment today is done with Invisalign First, an aligner system built specifically for the mixed dentition of a growing child. Rather than relying on brackets and wires, Invisalign First guides erupting permanent teeth and jaw growth using a series of clear, removable aligners custom made for your child’s mouth.
Signs Your Child May Benefit From Early Treatment
- Crowded or overlapping teeth as permanent teeth begin to erupt
- A crossbite, where the upper teeth sit inside the lower teeth when biting down
- A narrow or high arched palate
- Mouth breathing, snoring, or noisy breathing during sleep
- Difficulty fitting all permanent teeth as they come in
- A noticeable overbite, underbite, or shift of the lower jaw to one side
Not every child with these signs needs early treatment, and an in-person evaluation is the only reliable way to know for certain. If you have noticed any of these signs, a free consultation is a straightforward first step.
What to Expect: The Treatment Process
1. Free Consultation and Evaluation
Every case begins with a complimentary consultation that includes a clinical exam, digital x-rays, and a review of your child’s growth pattern, so we can confirm whether early treatment is needed and which option is the right fit.
2. Digital Scan and Custom Treatment Plan
Once we confirm early treatment is the right course, we take a 3D digital scan, with no messy impressions, and use it to build your child’s custom aligners or expander and map out the treatment plan.
3. Delivery and Wear Schedule
We walk your family through exactly how the appliance works, whether that is a full-time wear schedule for the Invisalign Palatal Expander, a removable schedule for Angel Kid or Invisalign First, or activation instructions for a traditional expander.
4. Ongoing Growth Monitoring
We see your child at regular intervals throughout treatment to track progress and make adjustments. Once the desired result is achieved, most children continue with periodic growth and development checks to plan for any treatment that may still be needed as their permanent teeth fully come in.
Total treatment time for expansion, including stabilization, is typically 3 to 8 months, depending on the appliance and the amount of expansion needed. Invisalign First treatment plans vary more widely based on each child’s specific case.
Frequently Asked Questions
What age should my child start early treatment?
The Canadian Association of Orthodontists recommends a first evaluation by age 7. Most children evaluated at this age are not treated right away and instead continue with free growth and development checks every 6 to 12 months until treatment, if needed, is the right next step.
What is the difference between the Invisalign Palatal Expander and Angel Kid?
Both are worn like a clear aligner rather than a traditional metal expander. The Invisalign Palatal Expander is worn full time, even at meals, and is recommended when a child needs a significant, skeletal amount of expansion. Angel Kid is removable and recommended for mild to moderate expansion, with the fewest office visits of any option we offer.
Will early treatment hurt my child?
Placement itself is not painful. Some pressure or mild discomfort is normal during active expansion or aligner wear, particularly in the upper front teeth, and is a sign the treatment is working. We offer the Dental Pain Eraser, a drug-free, needle-free option to ease this discomfort.
Will my child still need braces or aligners later?
Many children who complete Phase 1 treatment go on to need a second phase of treatment, braces or clear aligners, once their permanent teeth are fully in. Phase 1 treatment often makes that later treatment shorter and more straightforward. We will discuss your child’s likely path at their consultation and again as treatment progresses.
Will an expander or aligner affect sports or instrument practice?
Children can continue playing sports and instruments during treatment. We recommend a properly fitted mouthguard for contact sports. For children who play a wind instrument, Angel Kid, which is removable, is usually the best option.
Ready to Get Started?
If you have noticed signs of crowding, a crossbite, or mouth breathing in your child, or your child is approaching age 7, book a free consultation at any of our three New Brunswick locations. Dr. MacKenzie will evaluate your child’s bite and growth and recommend the right course of action, from watchful monitoring to Invisalign First, the Invisalign Palatal Expander, or Angel Kid.
Not sure where to start? Book a free consultation and we will evaluate your child at no cost and no obligation.
Written by: Dr. Liliya MacKenzie, an orthodontist in New Brunswick, Canada, and a graduate of Mount Allison University, McGill University, and the University of Rochester. Dr. MacKenzie is a specialist in Orthodontics and Dentofacial Orthopedics and a Fellow of the Royal College of Dentists of Canada. She has treated over 10,000 patients, has 20+ years of experience and is an orthodontist on the Cleft Lip and Palate Team at the Saint John Regional Hospital. Dr. MacKenzie has given over 50 lectures nationally and internationally on the topic of clear aligners and orthodontic care for children, teens, and adults.
