The Importance of Early Orthodontic Screening

The American Association of Orthodontists recommends that all children have a screening with an orthodontist no later than age seven. For certain individuals, treatment at a young age (before all the permanent teeth have come in) is very important. Failure to treat particular problems early can result in undesirable consequences, including:

  • Increased risk for tooth trauma
  • Destructive tooth wear
  • Permanent gum recession
  • Development of jaw/facial irregularities
  • Psychosocial problems


If such problems are not caught early, their correction can require lengthy, complex, and expensive orthodontic and dental treatments later. In fact, early intervention can prevent problems that otherwise would likely have required surgical corrections in the teenage or adult years.

Evidence-Based Orthodontics

Not all patients are candidates for early treatment. In fact, when specific orthodontic problems are not present, we prefer to wait to start treatment until all the permanent teeth have come in (or are nearly in); research has shown that in these situations, deferring treatment results in shorter and less expensive overall orthodontic treatment. For most patients, the opportunity for periodic evaluation by the orthodontist during growth and development will allow the appropriate treatment to be initiated at the appropriate time.

What is Normal and What is Abnormal?

For young patients in the mixed dentition (when there is a mixture of “baby” teeth and “permanent” teeth), we expect to see an “ugly duckling” stage of transitional development in which there may be spacing issues, along with minor protrusion and overbite concerns. There are many variations in this transitional stage of development, and perfect tooth alignment is not to be expected and is not a cause for alarm. What’s normal in a seven year old is that the dentition looks abnormal. As shown in the patient below, facial proportions and balance are good. She has both primary and permanent teeth that are developing normally for her age.


Normal Development

This is an example of normal facial growth and balance in a seven-year old patient.
This is an image of what the normal appearance of a seven-year old's teeth can look like from the front.

The following are common abnormalities that may require treatment

Image of an underbite or class III malocclusion
Image of spacing between the teeth
Image of protrusion or over jet
Image of open bite
Image of crowding of the teeth
Image of deep bite (overbite)
Image of posterior (back) crossbite
Image of anterior (front) crossbite