Basically, there are two main issues, the alignment of the teeth and the alignment of the jaws. To align all the teeth, they all must be erupted by the completion of the treatment. If there is a jaw alignment issue, the physical growth can become important as well.
Growth patterns vary with each person. In addition, dental development does not necessarily parallel physical growth.
The American Association of Orthodontics recommends the first orthodontic evaluation at age 7. The vast majority of children need no treatment at this age. However, this is generally a good time to evaluate. This allows us to determine any potential issues and advise on long term planning to maximize the efficiency of any treatment.
In general, we are not in favor of excessive “early treatment” (a “phase one” orthodontic treatment done before all the permanent teeth have erupted). Most early treatment cases require full treatment later.
In some situations, however, judicious use of some relatively simple appliances are very important to correct problems that are causing an immediate issue. Examples are crossbites, habits, severe protrusions, and unusual eruption problems. Many times, simply extracting some primary (baby) teeth can take care of the immediate issue and avoid early treatment.
Other factors to consider are the individual concerns of child and/or the parents, i.e., possible self esteem issues, concerns about potential damage from trauma, etc. Another very important factor is whether a move from the area is planned. In general, it is always preferable to begin and finish with one orthodontist. However, depending on the situation, it can be important to begin treatment even if a move is planned.
Only with an early evaluation can we assess all these factors and give you the best advice for your particular situation.