When to Start Orthodontics for Children: First Check-up Around Age 7, Early Treatment, Phase 1 and Phase 2
The Korean Association of Orthodontists (KAO, 대한치과교정학회) recommends a first orthodontic check-up for children at age 7. Around age 7 is when the permanent front teeth and molars erupt, so much information can be learned from the dental arch, and for some malocclusions treatment at this time is most effective. Having a check-up does not mean starting orthodontics right away; the result falls into cases where no treatment is needed, cases where growth is watched, and cases where early treatment is given.
Key facts
| First orthodontic check-up | Around age 7 (when the first permanent front teeth and molars erupt) (source: Korean Association of Orthodontists) |
|---|---|
| Check-up methods | Intraoral exam, radiographic exam, dental model exam (source: Korean Association of Orthodontists) |
| Cases for considering early treatment | Skeletal discrepancy, early baby tooth loss, missing or extra teeth, ankylosed teeth (source: Korean Association of Orthodontists) |
| Alveolar bone graft for cleft lip and palate | Around ages 8-10 if there is an alveolar bone defect (source: Korea Disease Control and Prevention Agency (KDCA, 질병관리청) National Health Information Portal) |
| Orthodontic pain | Usually fades within 3-4 days, with no major effect on nutritional intake (source: Korean Association of Orthodontists) |
When should a child have a first orthodontic check-up?
The Korean Association of Orthodontists recommends visiting the dentist for an orthodontic exam around age 7, when the first permanent front teeth come in. At this time the permanent front teeth and first large molars begin to erupt, so the dental arch and the growth direction of the jaw can be seen together.
To the question parents ask most about the best time for orthodontics, the Association answers that the right answer depends on the child. For some children it is right to start in the upper elementary grades or middle school after all the permanent teeth have come in, but certain malocclusions are effectively treated only early, so need is first checked with a check-up around age 7.
If a child has an abnormality involving the face and mouth from birth, such as cleft lip and palate, orthodontic and surgical treatment is planned according to the stage of growth from the newborn period.
What is checked at an orthodontic check-up?
Through an intraoral exam, a radiographic exam and a dental model exam, the dentist looks at whether the number of teeth and the upper-lower bite are normal, whether there is enough space for permanent teeth to erupt, and whether the upper and lower jawbones are growing in balance.
The result falls into roughly three types: treatment is not needed now; treatment is not given immediately and the growth of teeth and jaw is watched; or early treatment is needed. If it is decided to watch, the next check-up time is set to compare changes.
Check-up records become material for comparing growth changes when orthodontics is started later, so it helps to continue at the same clinic or to receive the records.
When is children's orthodontics started early?
The Korean Association of Orthodontists gives as a typical case for starting treatment early a skeletal discrepancy in which the upper and lower jaws do not grow in balance, showing a tendency toward a protruding lower jaw, a receding chin or facial asymmetry. This is because jawbone growth can be guided during the growth period.
If a baby tooth is lost early to decay or trauma, the neighboring teeth fall into the empty space and the dental arch narrows, so the permanent tooth may not come in at the right place. Cases of congenitally missing permanent teeth or extra teeth, and ankylosed teeth in which the root is fused to the bone and cannot erupt, also need early confirmation.
- Skeletal discrepancies such as a protruding lower jaw, receding chin or facial asymmetry
- Early baby tooth loss due to decay or trauma
- Missing permanent teeth, extra teeth, impacted teeth
- Ankylosed teeth in which the root is fused to the bone and cannot erupt
What are phase 1 and phase 2 orthodontics?
Treatment during the growth period that corrects jawbone growth problems and the space for permanent teeth to erupt is commonly called phase 1 orthodontics (pediatric orthodontics). The Korean Association of Orthodontists explains that at this stage problems with growth of the face and jawbone can be found early and corrected, and preparation can be made so the permanent teeth come in at the normal place.
Rather than ending with phase 1, it often leads on to comprehensive orthodontics (phase 2) that sets the normal bite after the permanent dentition is complete. However, there are also cases in which, thanks to phase 1, phase 2 becomes relatively simple or is no longer needed.
The KDCA explains that a child in the growth period may avoid surgery by improving skeletal problems with orthodontics, but an adult whose growth has ended needs surgery to improve a skeletal discrepancy.
What orthodontic signs can be noticed at home?
The Korean Association of Orthodontists recommends getting a precise diagnosis from an orthodontic specialist if the following are seen. A slight gap between the front teeth before the canines come in is normal, so there is no need to worry about that alone.
A habit of breathing through the mouth can affect face length and jawbone development, so if nasal congestion or a tonsil problem is also present, an ear, nose and throat consultation should be considered.
- Baby teeth fall out too early or stay in too long
- The front teeth bite in reverse, or the jaw looks protruding or small
- Snaggle teeth, or wide gaps between teeth
- Habits of mouth breathing, thumb sucking or tongue thrusting
- Upper and lower teeth do not meet, making chewing difficult
Common myths and facts
Myth: An orthodontic check-up can wait until all the permanent teeth have come in.
The Korean Association of Orthodontists recommends a first orthodontic check-up around age 7. For some malocclusions, treatment at this time is most effective.
Myth: A child who has orthodontics during the growth period grows less tall.
The Association explains that orthodontic pain usually fades within 3-4 days with no major effect on nutritional intake, and that improved bite and breathing may instead help growth.
Frequently asked questions
If my child has a check-up at 7, does orthodontics start right away?
No. Depending on the result, it falls into cases where treatment is not needed, cases where growth is watched, and cases where early treatment is given. If it is decided to watch, the child is checked again at set intervals to compare the order in which permanent teeth come in and whether there are changes in jaw growth.
For children's orthodontics, should I consult a pediatric dentist or an orthodontist?
The Korean Association of Orthodontists recommends consulting an orthodontic specialist who deals with jawbone and facial growth and development. Some cases also need pediatric dentistry, such as cavity treatment or a space maintainer, so care is coordinated to suit the child's condition.
Can my child tolerate an orthodontic appliance?
When an appliance is first put in it is uncomfortable for a few days, but usually the pain fades and the child adapts within 3-4 days. A removable appliance works only when a parent also keeps track of wearing time. Also teach the child to use a storage case so the appliance is not lost or broken.
Is children's orthodontics covered by health insurance too?
Ordinary orthodontics is non-covered regardless of age. Only orthodontic and orthopedic treatment for cleft lip and palate and notified congenital maxillofacial anomaly patients is covered by health insurance, and the treatment stage must be pre-registered with the National Health Insurance Service.
Is a thumb-sucking habit related to orthodontics?
The Korean Association of Orthodontists explains that habits such as thumb sucking, tongue thrusting and mouth breathing can affect malocclusion and jawbone growth. If a habit continues for a long time, discuss it at the orthodontic check-up, and correcting the habit early helps prevent malocclusion.
Related topics
- Orthodontics
- Pediatric Dentistry
- Thumb Sucking Habit
- Space Maintainer
- Types of orthodontic appliances
- Orthodontic duration