What Age for Orthodontics Eval?

Updated on April 25, 2015
M.D. asks from New York, NY
20 answers

Hi Moms,
This has changed so much since we were kids. At what age are kids usually evaluated by an orthodontist?

I was planning to ask the kids' dentist if my son should see someone, but their next appointment is not until after my insurance open enrollment period is over. And I know from experience that if I schedule the appointment a few weeks early, insurance won't cover it. But, if I need to add orthontics to my coverage for this year, I need to do it now.

I was thinking of just calling some orthodontists. But, I'm not sure. Do people usually just call up orthodontists, or do they usually get referred from the dentist?

For reference he is almost 9 and at previous appointments, the dentist said his bite was good (not over, under, or cross). And he had spaces between all his baby teeth, so she wasn't worried about crowding when the adult teeth came in. But as his adult teeth come in, they are not straight - but maybe they will move around as more teeth come in? Already the gap between his front teeth is closing as his eye teeth come in.

If I wasn't pushed by insurance decisions, I would definitely wait at least until after the summer dentist appointment - but if I wait, I can't change my mind in 6 months.

What can I do next?

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Featured Answers

S.G.

answers from Los Angeles on

My son was referred to the orthodontist by his dentist when he was 9 or 10 for a retainer.

ETA: In my sons case the retainer was necessary to move the adult teeth to make room for new adult teeth to come in.

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A.V.

answers from Washington DC on

My SS had braces so the dentist was keeping an eye on SD. By 8 she had spacers (I think) and by 11 she had braces herself. Her teeth were 2 years ahead of her age, so people would ask us if she was really x old (yes). IMO, if the dentist thinks that there is a problem, then take him in. At this age, you might end up doing braces twice if the ortho is one of those that pushes braces for young kids and then a repeat in their teens.

Even if you wait a year, he'll be just 10. My SS did not get braces til 12 or so. I think you have time to shop.

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T.S.

answers from San Francisco on

I just went by what my dentist recommended. When he said it was looking like they should be seen by an ortho that's when I took them in.
I think it's fine to wait until your next appointment. Ortho treatment isn't usually something you need to rush into, unless your son had major issues (which he doesn't seem to) save yourself a year of extra insurance payments!

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S.E.

answers from Wichita Falls on

Our dentist preferred to wait till at least all the baby teeth were lost (unless there was a major problem). Our daughter had a few stubborn teeth and was 13 before she had them put on. You could call your dentist and inquire at what age/milestones he prefers before suggesting braces.

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D.B.

answers from Boston on

If your dentist hasn't even raised the issue, I don't see any reason for you to start calling around to orthodontists. The evaluation, if indicated, isn't based on age - it's based on the timing of baby teeth falling out and permanent ones coming in, X-rays that show the position of teeth that haven't erupted yet, jaw structure, history of things like thumb-sucking, and more.

The most you should do now is start a casual list of orthodontists from friends - what they like, don't like, etc. But each child's case is different, and each family's situation is important (what you expect in terms of communication, what your wait times will be, how long your child will be in braces if at all, and much more). When I was a kid, I waited ridiculous amounts of time in the waiting room with 20 other kids, then went into one of 3 exam rooms where I sat and waited even longer while the orthodontist rotated from room to room, and then when he finally showed up it was "Bite, open, bite, open. see you in 3 weeks." My mother refused to question this.

Now, if you have an insurance issue, you need to call the regular dentist to discuss this. But if the subject hasn't even come up, then there is zero urgency about it. I would discuss it at the time of the summer appointment and ask what you should be planning on, that you have enrollment issues to consider. Every dentist and orthodontist worth their salt would understand insurance considerations (after all, they want to get paid!). I would think 9 is pretty young unless there's a huge problem - and how teeth come in at first vs. how they line up as the child grows are totally different questions. The dentist no doubt has 1 or more orthodontists to recommend, and you won't be limited to those particularly if your insurance gives you a list of preferred providers. You can also ask your child's pediatrician for referrals.

Remember that, if you have paid for X-rays at your dentist's office, you own them. That means they can be forwarded to any prospective orthodontist so you don't have repeated expenses. Sometimes additional ones are needed - full 360 degrees, for example, but you can certainly question if what's already taken (and current) can be used.

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J.B.

answers from Boston on

I would just call your dentist, explain the insurance situation and ask if they see anything in your son's history that they think would warrant orthodontic work in he the next year.

Chances are, if they haven't noticed anything by now then you have at least another year or two before any problems may need to be evaluated. My oldest son and step-daughter are both 17 and an ortho consult was brought up when they were 12, but there was no hurry with them. They both had a couple of spots of crowding or misalignment, and SD had some rotated molars, but we could have had them taken care of at 13, 18, 27, never...it didn't matter. My SD opted to start ortho this past year and my son decided that he didn't want to bother as his crowding is with the lower teeth, which aren't visible when he talks or smiles.

On the other hand, both of my younger boys (9 & 11) were identified as ortho candidates by the time they were 4 & 6 because of severe underbites/crossbites, which they inherited from me. Those are the kinds of things that get treated at age 7/8. If they haven't noticed anything like that yet, you probably don't need to worry about ortho for a while.

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B.D.

answers from Pittsburgh on

I know of one particular orthodontia group in Pittsburgh that likes to get them in, what I consider to be, too young. I have a friend whose daughter has had her braces on and off already and she doesn't even have all of her adult teeth.

My pediatric dentist had told me over the years that my oldest would need braces 'eventually'. He finally sent her for an evaluation at 11. She's had them on for about a year now.

My youngest is more petite than my oldest. I feared that she would need the expander and the whole nine yards. Her eye teeth are high and not in line with the rest of her teeth. At 9 he told me that she will 'eventually' need braces and that she still has teeth to lose. I expressed my concern that she would need more intense orthodontia. He told me 'nope' just the standard to bring those teeth in line.

If I were in your shoes, I would call your son's dentist and ask him how far off an orthodontic evaluation is. Then you will know. It may not be until he loses all of his baby teeth.

With all of our dental insurance policies over the years, orthodontia was always part of the plan and not a separate line item. Now we've been given the option between a basic dental and premium dental. The difference in the orthodontia benefit was always about $300 dollars and the premium difference wasn't that much different and the maximum benefit amount was higher too.

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A.L.

answers from Atlanta on

From what you are saying, the chances are low that he's going to need ortho work done immediately. So even if the dentist suggests at this visit that he gets checked out by the ortho, you still could wait the year until you can add that benefit.

If our experience is useful to you... we were referred to an ortho by our son's dentist when he was about 7; that's because his front teeth were already coming in at a sticking-way-out angle along with an overbite, and the x-rays showed that the issues were only going to get worse. We are now on Phase 2 (at age 13) and he is almost done. His little sister(almost 10) has not been referred to an ortho yet, even though she has some noticeable spacing issues. The dentist is still waiting for more adult teeth to come in, and she doesn't have the buck teeth issue, apparently. So it really does depend on the kid. Good luck!

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A.L.

answers from Las Vegas on

I tend to think dentist refer kids way too young... they kept referring my son when he was really young, around 7 and he still had some baby teeth...... why should I adjust anything until all the teeth have come in... so I waited until NOW.. he is 13 with an overbite and has braces... part of me still wonders IF I really should have gone through with it.. I have an overbite and my teeth are straight and it doesn't bother me in the least..
IF anything, try and get a couple different opinions and do it with a dentist who ISNT getting some kind of referral kick back... many of them do.. so make sure yours isn't... and then check around with all types of plans.. they range greatly in price.. good luck

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B.C.

answers from Norfolk on

About 7 yrs old (around 2nd grade).
Our dentist took a panoramic xray so we could look at how all our sons adult teeth were developing - it looked like a traffic jam!
He recommended an orthodontist.
After some time with expanders and 2 yrs with braces (he finished by the end of 6th grade) his teeth were straight and perfect!

Additional:
The reason they are doing expanders/braces earlier is because they can work with the bones as they grow - the roof of the mouth is still soft (hard palate hasn't grown in and knit yet) and it's way easier to nudge a growing bone to grow in a good direction (that's what expanders do) than it is to move adult teeth around in bone that has already set up.
Starting later means way longer total time in braces.
Starting earlier means you expand the jaw bones so they have enough room and then they have relatively minor adjustments with braces for alignment.
I had 8 adult teeth pulled and 7 years of braces - that's what they did in the 70's.
Our son had 6 months expanders and 2 years braces - no adult teeth pulled.
Best time to work with the mouth is WHILE it's still growing!

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E.B.

answers from Beaumont on

My kids both got them at 10 but in both cases their teeth were horrible. Not sure if that makes any difference. I would just call the orthodontist you are planning on using and ask. If you don't have one, call the dentist for a referral. You are wise to start planning. It's a lot of money.

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D.N.

answers from Chicago on

If the dentist has not mentioned a problem, I would wait. My older girls do need braces. They are 16 and they will go this year. I was told at 13 to take them since all baby teeth were finally gone but no money to pay and my insurance does not cover. After we have the next check up, I will have them evaluated for both regular and speed (damon) braces.

Of course, it is very possible your son will not need braces. I didn't have them and my teeth and straight, no over or under bites etc.

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J.C.

answers from Anchorage on

My boys were both referred to the ortho at different ages. My oldest was 10 and he was sent for top braces after having several teeth pulled. My younger son started seeing the ortho at 8, but only because he ended up with abscessed molars that had to be pulled and he needed a space saving device to keep his other teeth from moving in the couple of years it will take for the adult molars to move in. Really the only one who can tell you is your dentist or by having a consult with ortho.

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L.O.

answers from Detroit on

orthos want to see them around age 7. so it is time for an eval. things like expanders are done young as their mouth is still growing and easy to move things.. pick an ortho close by as you go often ...

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C.S.

answers from Las Vegas on

My daughter is 9. She started losing teeth in preschool and has now lost 3 molars. Her bite is not wonderful, but also not horrible. In my view, unless the bite is off so bad that it affects closing their mouth or eating, I am a believer in waiting. My dentist said (in so many words) it's a business.

My daughter is still a thumb sucker, so we are waiting for her to stop, completely. If she didn't suck her thumb, I would be considering an appointment to get started, but only because she has molars coming in. I don't get braces on baby teeth.

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J.P.

answers from Lakeland on

My daughters dentist recommended us to an orthodontist because of the way her teeth were coming in and the fact that her bite was not straight. She's 8 and has only one baby tooth left to come out.

If your son was showing problems I would think the dentist would have said something. Can you add it and then take it off next year if you don't need it? You can also call the dentist and talk to him/her and get their opinion without going for an appointment.

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S.S.

answers from Chicago on

wait for your nest appointment. if it turns out they want him to see someone then you can just scheudle it for the next open enrollment period. a few months wont make any difference.

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S.H.

answers from St. Louis on

your dentist will be the best judge for if/when your child will need an ortho consult.

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M.P.

answers from Portland on

The dentist told both of my grandchildren that they will need braces when they're older. Older because their mouth is still growing. if I remember correctly waiting has something to do with still having teeth waiting to come out. He told my 14 yo granddaughter now it's now. it's still too early for him.

Their dentist will answer your question on the phone.

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G.B.

answers from Oklahoma City on

He's overdue. Add the insurance if you think he needs braces.

Almost all kids that go to the dentist regularly can call their dentist and say "Hey, I am looking at my insurance options for next year and need to know how XXXX's teeth are doing. Are there any concerns that I need to plan for? Does anything need watching? Do you think he might need braces?"

I think that a good dentist will know if your child might need braces and why. Is it because they have too many teeth for a small jaw bone, is it because they're crooked enough to hinder eating, what would be the reason for braces?

Then it's not "Hey, I'm going to get orthodontic insurance, let's do braces".

Our dentist says my granddaughter might need braces because she has a tooth that is a lot higher on the gum than the others. She wants it to come down and be even with the others. It's not a medical issue but more of a cosmetic thing. I don't think our insurance would cover than so she may have to live with a tooth that's higher than the rest. BUT our dentist has already visited with us about the tooth and knows what's what.

That's my point. Her own dentist should be able to tell you everything you want to know about your kiddo's teeth.

Most of my friends kids have started working towards their adult teeth look since they were 7 or 8.

They have teeth pulled if they have small mouths, they have Bionaters put in to encourage their jaws to expand or they wear a palate expander since age 7, and they know where they're going with treatment so the adult teeth will look great.

All by age 8 or 9 at the latest. Braces may not go on at age 8 or 9 but they have a plan and know if they're going to be needed.

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