What is the right age for braces? It’s one of the most common questions asked of orthodontists. There is no one right answer when they ask this question, but the answer is a little more complicated than you might think, and here’s why. The initiation of orthodontic treatment is highly individualized and should be evaluated accordingly. While two-phase orthodontic treatment has become popular, we do not believe that it is always necessary. We believe that early evaluation is important, beginning at the age of 7, but treatment should be limited to changing the shape of the upper jaw when necessary, helping to alleviate harmful habits, and monitoring the eruption of permanent teeth. There is a wide array of appliance designs, both fixed and removable, that can be effective and a discussion with all involved leads to the optimal treatment plan.
First Phase Orthodontic Treatment
There’s much more to orthodontics than braces. Your child may need orthodontic treatment at age 9, but not need braces. Braces are the second step in orthodontic treatment. The initial step is called first phase or early orthodontics.
Your child should first visit the orthodontist by age 7. If that sounds young to you, that’s the point—by starting orthodontic treatment younger, we can influence the jaw as it grows, before it fuses in place. This is a more gentle, effective way to treat (and prevent) orthodontic issues. Many children don’t need treatment after their first appointment or even their second or third. Instead, we monitor the growth of the jaw and make sure there’s sufficient room for the permanent teeth.
If orthodontic treatment is needed, it’s in the form of a habit appliance, space maintainer, or palate expander. Habit appliances stop children from thumb or finger sucking and help retrain proper tongue position, while space maintainers are used to ensure that permanent teeth have the space they need to erupt. Palate expanders widen the upper jaw.
Between first phase orthodontic treatment and second phase orthodontic treatment is a rest period. The length of this time will vary depending on your child’s orthodontic issues and our treatment goals. Often, a retainer will be worn to ensure that the jaw maintains its shape. During this time, we will wait for the primary teeth to fall out and the permanent teeth to erupt and replace them.
Second Phase Orthodontic Treatment
It’s the second phase in which braces are needed. Ideally, first phase treatments will take care of most issues with the jaw, which means that patients won’t need to wear braces as long as they would without this early intervention. The average length of second phase orthodontic treatment is 12 to 18 months.
With two-phase-orthodontic treatment, children typically get braces between the ages of 10 and 14. Every child is different, though, and yours may need braces sooner than this. In general, we look to start the second phase of orthodontic treatment only once all of the permanent teeth have erupted. This is particularly true in the case of two-phase orthodontics because after the first round of treatment, most or all of the issues with the jaw shape and size should have already been corrected—what’s left is to straighten the teeth to make sure they look beautiful and function well together.