Paediatric orthodontics involves the assessment of tooth eruption, jaw development and bite relationships throughout a child’s growth period. The aim is not to begin treatment at an early age for every child, but to identify whether a developing orthodontic problem is present and, where necessary, to plan the appropriate timing for monitoring or treatment.
During childhood, the mixed dentition period, when both primary and permanent teeth are present, can provide important information about tooth eruption patterns and jaw development. The American Association of Orthodontists recommends that a child’s first orthodontic evaluation should take place no later than approximately the age of 7. However, this does not mean that every child should begin active treatment at the same age.
For children in Bursa who require an assessment of tooth alignment, bite or jaw development, Dr. Dt. Ebru Çetinkaya Tokmak evaluates the child’s current stage of development during an orthodontic examination and determines the need for monitoring or treatment on an individual basis.
What Is Paediatric Orthodontics?
Paediatric orthodontics refers to the orthodontic assessment of tooth eruption, dental alignment, the relationship between the jaws and the development of the bite during a child’s growth and development.
Orthodontic assessment during this period can help monitor both existing problems and conditions that may potentially develop as the child grows.
Early orthodontic treatment is not necessary for every child. For some children, periodic monitoring may be sufficient, while for certain orthodontic problems, treatment may be considered at a specific stage of growth. Accurate diagnosis, treatment priorities and appropriate timing are fundamental when evaluating the developing dentition.
When Should a Child Have Their First Orthodontic Examination?
There is no single age at which active orthodontic treatment should begin for every child.
However, around the age of 7, when both primary and permanent teeth are usually present, it may be possible to assess tooth eruption patterns and identify certain bite problems. For this reason, the American Association of Orthodontists (AAO) recommends that children have their first orthodontic evaluation no later than approximately the age of 7.
The purpose of an orthodontic assessment at this age is not necessarily to begin treatment.
Following an orthodontic evaluation:
- No treatment may be required
- Periodic monitoring of dental and jaw development may be recommended
- Treatment may be planned for a later stage
- Early management of a specific orthodontic problem may be considered
Therefore, the recommended age for a first orthodontic examination and the appropriate age to begin treatment are not the same thing.
When Might a Child Need an Orthodontic Assessment?
Certain dental and bite characteristics in children may indicate the need for an orthodontic assessment.
These may include:
- Noticeable dental crowding
- Early or delayed loss of primary teeth
- Delayed eruption of permanent teeth or suspected abnormal eruption direction
- Anterior or posterior crossbite
- The lower jaw appearing noticeably forward or backward
- A narrow upper jaw
- Prominent upper front teeth
- Open bite
- Noticeable shifting of the jaw during movement or when biting
- Suspected impacted or unerupted teeth
The presence of one of these findings does not necessarily mean that active treatment is required. The need for treatment is determined by evaluating the child’s dental development, growth stage and existing orthodontic condition together. Assessment of the developing dentition may include monitoring eruption problems, bite abnormalities and dentofacial development.
Can Problems with Primary Teeth Affect Orthodontic Development?
Primary teeth play an important role in the development and eruption of permanent teeth.
If a primary tooth is lost earlier than expected or remains in the mouth for longer than expected, it may in some cases affect the space available for the eruption of permanent teeth.
However, early loss of a primary tooth does not always require orthodontic treatment. The current dental condition and the development of the permanent teeth should be evaluated together.
When Should Delayed Eruption of Permanent Teeth Be Evaluated?
The timing of permanent tooth eruption can vary between children.
However, an assessment may be appropriate when there is a noticeable delay despite the corresponding tooth on the opposite side having already erupted, or when a problem with the eruption path is suspected.
Where necessary, radiographic imaging may be used in addition to the clinical examination.
Is Early Orthodontic Treatment Necessary for Every Child?
No.
Early assessment and early treatment are not the same thing.
While certain orthodontic problems may benefit from being addressed at specific stages of growth, many children may wait until more of the permanent teeth have erupted before active treatment begins. The British Orthodontic Society also notes that orthodontic treatment for many children begins when most of the permanent teeth have erupted, although earlier intervention may be appropriate in certain specific situations.
The main purposes of early orthodontic assessment can be considered as:
- Identifying an existing orthodontic problem
- Monitoring growth and development
- Determining the appropriate timing for treatment
- Avoiding unnecessary or poorly timed treatment
Is Two-Phase Orthodontic Treatment Necessary for Every Child?
No.
For some children, a first phase of treatment may be planned during the growth period to address a specific problem, followed by a second phase at a later stage to align the permanent teeth.
However, not every child requires two-phase orthodontic treatment. The treatment plan should be created individually according to the existing orthodontic problem.
What Orthodontic Treatments Can Be Used for Children?
The orthodontic methods that may be used for children vary according to the child’s age, dental development and existing orthodontic problem.
Where appropriate, treatment options may include:
- Fixed or removable orthodontic appliances
- Palatal or jaw expansion appliances
- Functional appliances
- Space-maintaining appliances or procedures
- Fixed braces treatment at a later stage
- Clear aligner systems in suitable cases
Not every appliance or treatment method is suitable for every child. Treatment selection should be based not only on age, but also on the orthodontic diagnosis and the objectives of treatment.
How Is Paediatric Orthodontic Treatment Planned?
Orthodontic assessment in children may involve several stages.
Orthodontic Examination
The current alignment of the teeth, the eruption status of the permanent teeth and the bite relationship between the upper and lower teeth are evaluated.
The child’s stage of growth and development is also an important part of treatment planning.
Assessment of Dental and Jaw Development
The condition of the primary and permanent teeth, the space available for tooth eruption and the relationship between the jaws are evaluated.
At this stage, it may be determined whether active treatment is required or whether monitoring the child’s development would be more appropriate.
Obtaining the Necessary Diagnostic Records
Depending on the child’s individual condition, the following may be used for treatment planning:
- Clinical photographs
- Digital intraoral records
- Radiographic images
- Orthodontic measurements
Determining the Appropriate Timing for Monitoring or Treatment
Following the examination, active treatment may not be started immediately for every child.
For some children, tooth eruption and jaw development may be monitored at regular intervals. When active treatment is required, the appropriate timing and orthodontic method are planned individually according to the child’s current condition.
Why Is Jaw Development Monitored in Children?
Because jaw development continues throughout childhood and adolescence, certain bite and jaw relationships may change over time.
In children with a narrow upper jaw, noticeable differences in the relationship between the upper and lower jaws, or functional bite problems, assessment of growth may be important when determining the appropriate timing of treatment.
However, growth-related orthodontic approaches do not have the same effect on every orthodontic problem. Treatment decisions should therefore not be based solely on a child’s external appearance.
Can Thumb Sucking and Similar Habits Affect Orthodontic Development?
Certain oral habits that continue for an extended period may affect the development of the teeth and bite.
The duration, frequency and intensity of the habit are important. A clinical assessment is required to determine whether an existing bite problem is present.
Can a Child Need Further Orthodontic Treatment After Early Treatment?
Orthodontic treatment carried out at an early age does not always mean that a child will not require further orthodontic treatment later in life.
Some early treatments are intended to manage a specific developmental or bite problem. A second phase of orthodontic treatment may be required when most or all permanent teeth have erupted in order to achieve more detailed alignment of the teeth.
For this reason, the purpose of early orthodontic treatment and the subsequent monitoring process should be evaluated individually at the beginning of treatment.
Paediatric Orthodontics in Bursa
When children in Bursa undergo orthodontic assessment because of dental crowding, tooth eruption problems, crossbite or concerns relating to jaw development, both the child’s chronological age and their stage of dental and physical development should be taken into consideration.
During a paediatric orthodontic assessment performed by Dr. Dt. Ebru Çetinkaya Tokmak, tooth eruption, current dental alignment, bite relationships and jaw development are evaluated together.
For children who do not require active treatment, development may be monitored at regular intervals. Where treatment is required, the appropriate timing and orthodontic approach are planned according to the child’s individual condition.
Frequently Asked Questions
At what age should I first take my child to an orthodontist?
Around the age of 7 is generally considered an important time for an initial orthodontic assessment. However, having an examination at this age does not necessarily mean that treatment will begin.
Can a 7-year-old child have braces?
Not every child needs braces at the age of 7. Early treatment may be considered for certain specific orthodontic problems, but many children only require monitoring at this stage, with comprehensive orthodontic treatment planned for a later period.
Can crowded teeth in children straighten naturally?
The appearance of the teeth may change as additional teeth erupt, but it would not be accurate to assume that every case of crowding will resolve naturally. The available space and dental development should be evaluated.
Can an orthodontic examination be performed while primary teeth are still present?
Yes. Orthodontic assessment can be performed during the mixed dentition period when both primary and permanent teeth are present.
Can children use clear aligners?
Clear aligner systems may be considered at an appropriate age and for suitable orthodontic conditions. However, the child’s ability to comply with treatment and the tooth movements required are important factors when selecting the treatment method.
Does early orthodontic treatment prevent the need for braces later?
Not always. Some children may require a second phase of orthodontic treatment after early treatment to align the permanent teeth.
Content Last Updated: 18 July 2026
This content has been prepared for general informational purposes. Individual monitoring, diagnosis and treatment planning are determined following an orthodontic assessment.