One of the most common questions parents ask at dental checkups is some version of: “Do you think my child will need braces?” The honest answer is that the earlier an orthodontist evaluates your child, the clearer that answer becomes — and the more options you have.
What age should a child first see an orthodontist?
The American Association of Orthodontists recommends that all children receive an orthodontic screening by age 7. This does not mean treatment begins at age 7 — in fact, most children who are evaluated at this age simply go on an observation schedule and begin treatment later. But age 7 is when the first permanent molars and front teeth have typically erupted, giving an orthodontist enough to work with to assess the bite, jaw development, and incoming tooth patterns.
At Pediatric Dentistry & Orthodontics of Salem, the first orthodontic consultation is always free.
What are the signs that a child may need orthodontic treatment?
You do not need to wait for a referral to notice potential issues. Here are common signs worth discussing with a dentist or orthodontist:
- Early or late loss of baby teeth — losing baby teeth significantly earlier or later than peers can affect how permanent teeth erupt
- Crowding — permanent teeth that appear to be coming in crooked, overlapping, or in the wrong position
- Gaps between teeth — spacing issues that do not resolve naturally as more teeth erupt
- Difficulty biting or chewing — children who avoid certain foods or complain about biting may have bite alignment issues
- Mouth breathing — children who consistently breathe through their mouths may have underlying jaw development concerns
- Thumb sucking or pacifier use past age 4 — prolonged habits can reshape the jaw and move teeth out of position
- Teeth that do not meet properly — an overbite, underbite, crossbite, or open bite visible when your child closes their mouth
- Facial asymmetry — one side of the jaw appearing higher or more prominent than the other
Not every one of these signs means braces are needed — some resolve on their own as a child grows. But an orthodontic evaluation provides clarity.
What is early orthodontic treatment (Phase 1)?
Early or Phase 1 orthodontic treatment refers to treatment that begins while a child still has a mix of baby and permanent teeth, typically between ages 7 and 10. It does not involve straightening all the teeth — that comes later. Instead, early treatment addresses specific structural problems that are better corrected while the jaw is still growing and more responsive to guidance.
Early treatment may be recommended to expand the upper jaw to create space for crowded teeth, correct a crossbite that is causing the jaw to shift to one side, or reduce the risk of injury to protruding front teeth. Not every child needs early treatment — Dr. Alghanem will only recommend it when there is a clear benefit to starting now rather than waiting.
What about braces for teenagers?
Comprehensive orthodontic treatment — the kind that aligns all the teeth and corrects the bite — most commonly begins in the early teen years once all or most permanent teeth have erupted. At PDOS, we offer several options for teens: traditional metal braces, LightForce custom braces, and clear aligners. Dr. Alghanem will help you and your teen choose the approach that fits their lifestyle, timeline, and smile goals.
Ready for an evaluation?
Dr. Tofool Alghanem is a board-certified orthodontist at Pediatric Dentistry & Orthodontics of Salem, Salem, NH. Initial consultations are always free. Schedule an orthodontic consultation →