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The Right Age for Braces

Sandy TANG, Orthodontist

Many parents bring their kids to our clinic when their four front teeth erupted around age 7. These front teeth always draw lots of attention since they are the 1st group of adult teeth replacing the baby teeth. When the front teeth appear to be crooked, protruded, have underbite or gaps, parents always anxious to know if the kids need braces. Some believe it’s wise to start early… some are influenced by other kids in the same class who already started braces.

The benefit of getting the teeth straight earlier is it’s easy for the early-erupted teeth to be cleaned so reduces the chances of cavities and gum disease. However, since all the permanent teeth will erupt till age 12, getting the braces as early as 7 or 8 also means possible to have the brace for the 2nd time at teen. That’s one of the criticisms of early treatment: Kids in braces for a long time that may increase the side effect.

So despite the allure of getting it over with young, starting early is not right for every child. Many studies showed that when to get braces strongly depends on the treatment required and the psychology of the kids.

For example, Dr. William Proffit, a professor at the University of North Carolina’s School of Dentistry in Chapel Hill did three major, randomized clinical trials for Kids with class II malocclusion, commonly referred as Bucked teeth, and found there is no benefit to start the braces early. According to him, “Early treatment is more costly both in terms of the amount of money you have to pay and the number of visits you make, and there is a greater burden of treatment with no benefit for most children.”

On the other hand, for Class III malocclusion, commonly referred to as an underbite, where the lower jaw is too big or the upper jaw is too small, an early orthodontic treatment around age 8 is very necessary. Treatment for this group of patient is to boost the growth of the upper jaw, and the upper jaw reaches its growth peak at age 7-9, so the optimal time for treatment closed at age 10.

For the majority of kids who have the class I malocclusion, early treatment to correct the crowding and rotation is optional. One important reason to start the treatment early is the teeth are very unattractive and the kids are teased in school, the early treatment with braces could make them more socially acceptable.

In addition, some stomatological GP can provide orthodontic treatment, but parents should be aware that “orthodontists are specialists who first complete all the dentistry education and then receive the dental orthopedics training for 2 to 3 years. The purpose of this training is to learn how to properly move teeth”. American Association of Orthodontists recommends having children screened by an orthodontist no later than age 7 to evaluate what the best age for treatment is.

In summary, when judging the best timing for the children to receive orthodontic treatment there are several principles for the parents to follow:

  1. Individualized treatment: Kids are different, and the treatment plan should be individualized.
  2. Evaluate both the pros and cons of the early treatment.
  3. Maximize the cost-effect of the orthodontic treatment.
  4. Have the kids screened by orthodontist when condition permits.