Evaluation for Children
Orthodontic organizations, including the American Association of Orthodontists (AAO) and the Canadian Association of Orthodontists (CAO), recommend that children have an orthodontic evaluation by age 7.
Orthodontic evaluation during childhood is recommended because some orthodontic conditions are best identified and assessed while the incisors are erupting and the jaws are developing.
The goal is to identify developing orthodontic conditions and determine whether observation, monitoring, or early intervention is appropriate.
Treatment Pathways
There are two possible pathways based on clinical findings.
Phase 1 orthodontic treatment when a defined condition is present.
Observation when development is within acceptable limits.
Phase 1 Orthodontic Treatment
Phase 1 orthodontic treatment is limited intervention during the mixed dentition when a defined orthodontic condition is present and early treatment may provide a clinical advantage during growth and development.
Phase 1 treatment is individualized according to the orthodontic condition being addressed. Treatment may include maxillary expansion, growth modification, space maintenance, eruption guidance, or observation with continued monitoring.
Treatment recommendations depend on the clinical findings, stage of dental development, growth and development, and treatment objectives identified during the orthodontic assessment.
Phase 1 treatment does not eliminate the need for future orthodontic treatment. Reassessment is required as the succedaneous dentition develops and erupts to determine whether Phase 2 orthodontic treatment is indicated.
When Phase 1 Treatment May Be Recommended
Maxillary Transverse Deficiency
The upper arch is narrow relative to the lower arch.
Sagittal Discrepancy
The upper and lower jaw relationship may present as increased overjet or an underbite.
Vertical Discrepancy
The relationship between the upper and lower teeth may present as a deep bite or an open bite.
Arch Space Deficiency
Available space is insufficient to accommodate the dentition within the existing arch form.
Premature Loss of Primary Teeth
Premature loss of primary teeth may reduce available arch space and increase the risk of crowding or altered eruption of the succedaneous dentition.
Functional and Habit Screening
Certain oral habits and functional patterns may influence dental development, oral function, and long-term stability. Screening is performed to identify factors that may warrant observation, monitoring, or referral.
Tongue Thrust
Tongue thrust swallow may be present in association with developing malocclusion and may influence tooth position and orthodontic stability. Orofacial myofunctional assessment may be recommended when indicated.
Clenching and Grinding
Clenching or grinding may be present and may be associated with dental wear, muscle tenderness, or jaw discomfort. Identification of these habits may assist with treatment planning and long-term monitoring.
Breathing and Sleep
Mouth breathing or snoring may be present and may be associated with altered oral posture and dentofacial development. Further screening or medical assessment may be recommended when indicated.
Follow-up and Monitoring
When treatment is not indicated, follow-up visits are used to monitor growth, tooth eruption, and changes in bite relationships. Reassessment timing is based on developmental milestones and clinical findings.
Explore Related Orthodontic Information
Additional information about orthodontic care at different stages of development is available below.