Orthodontics for children

The Canadian Association of Orthodontists (CAO) and the American Association of Orthodontists (AAO) recommend that all children have a first orthodontic evaluation by age 7.

Why a 7-year assessment?

It is around the age of 6-7 years that the first permanent molars erupt and establish the posterior occlusion.
At this point, it is already possible to assess the relationship between the teeth and the jaws in 3 dimensions (front-back, width and height) and to detect several dental and skeletal problems, as well as functional deviations of the lower jaw.
The incisors have started to erupt and certain problems, such as crowding, dental rotations, closed occlusion (too much vertical overhang between the teeth), anterior open bite, certain habits and facial asymmetries, can be identified.
Note that there may be variations in the development and dental eruption of children. Some are earlier while others are slower. Thus, it might be appropriate to see some children around 6 years old while around 8+ years old would be adequate for others. However, the age of 7 is a good average for a first orthodontic evaluation.

Should we intervene?

Early assessment does not imply the need for early intervention.

For some, a timely assessment can lead to significant improvements if orthodontic intervention is indicated, while for others the immediate benefit of an early assessment will be peace of mind for parents.

Several intervention and interception procedures can be undertaken at an early age, which can help minimize the severity of developing problems.

The benefits of early orthodontic intervention

For patients in whom intervention at an early age is indicated, such preliminary treatment provides the opportunity:

to favorably influence the growth of the jaws;
to balance the width of the dental arches;
improve eruption patterns;
to reduce the risk of trauma to the upper incisors which are too advanced;
to correct oral habits;
improve aesthetics and self-confidence;
to simplify and/or reduce the duration of subsequent corrective treatment in orthodontics;
to minimize the possibility of permanent teeth becoming impacted;
improve certain speech problems;
to preserve or recover the space necessary for the eruption of permanent teeth.

An early orthodontic evaluation will probably not avoid the need to intervene again later, but it can lead to a simpler and more effective treatment for patients while reassuring them about their dental condition.

Exemples d’interventions orthodontiques précoces.

Examples of early orthodontic interventions

Here are some orthodontic procedures that may be indicated in patients as young as 7 years old:

Palatal expansion to widen a too narrow palate or upper jaw;
Control of finger or thumb sucking habit;
Use of an oral screen to try to stop an infantile or atypical swallowing habit;
Selective extractions to help the eruption of permanent teeth;
Correction of an anterior or posterior crossbite.

Even if no problem seems apparent at first glance during a visual examination of the teeth of your 7-8 year old child, ask for an initial evaluation. Taking a panoramic X-ray around this age can reveal a lot about the dental future and the bite that is developing in your child.

Observation period, how often are observation visits?

During the initial evaluation, if nothing major or abnormal requiring intervention is detected, the child will be placed under “observation” and evaluated again at regular intervals of 12 to 18 months to follow the evolution of his teeth.
Appropriate recommendations will be made in a timely manner during subsequent visits.
The dentist may recommend taking a panoramic X-ray to:
- get an overview of the developing dentition;
- follow the development and eruption of the dentition;
- ensure that all teeth are present and developing normally;
- assess the direction of eruption of the teeth and the space available for them to come out of the mouth;
- to anticipate and minimize the appearance of certain problems.
In patients with mixed dentition, that is to say those who still have temporary and permanent teeth, during the supervision of the eruption of the teeth, nature must be allowed to act between each examination and intervention (if there is place to intervene). It is therefore usually sufficient to reassess the development of the dentition every ± 12 months. There is no benefit in seeing patients more frequently unless a particular condition needs to be monitored more closely.