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Timing is Everything…



When is the best time to begin orthodontic treatment? This is a question that is often foremost on the mind of parents as they seek a specialist’s consultation for their child’s orthodontic care. The answer can appear to be confusing and even seem to be contradictory. Some individuals claim that early treatment (age 7-10) can prevent the need for full braces when the permanent teeth are fully erupted or eliminate the need for permanent tooth extractions. Some claim that early treatment can produce results that are not otherwise attainable.

Most of the time this isn’t true.



Over the years, we have had the opportunity to treat and evaluate many patients with early treatment protocols and “least-intervention time” protocols and then review the results in the following areas: excellence of the final result, duration of intervention, number of appointments, and ongoing patient motivation.

Combining this experience with advances in wire and appliance technology, we have concluded that for the vast majority of young patients, it is best to delay treatment until most, if not all, the permanent teeth have erupted.  Moreover, current university-based research data supports this conclusion as well.

The following is a list of the five major advantages and benefits of waiting:

1.   Decreased time in braces and fewer appointments. This results in:

    1. less time absent from work or school
    2. Less chance of breakage.
    3. Less patient burnout.
    4. less chance of tooth scarring and root shortening

2.    Growth is occurring most rapidly during the early adolescent years which improves
treatment effectiveness.

3.    Understanding and cooperation are better when a child is more mature.

4.    Total time in braces, retainers, and maintainers is less, so the cost is less.

5.    Every patient, without exception, wants treatment for absolutely the shortest
possible time.

The best time varies somewhat, but is usually between the ages of 10 1/2 and 12 1/2. Treatment begun during this ideal window of opportunity results in braces being on for 10 to 30 months instead of 3, 4, 5, or even more years. Also, the final result resolves all the bite problems, start to finish, not just some of them. Early treatment protocols always involve multiple steps of active tooth movement followed by retainers followed by more treatment to perfect the bite. The time and expense add up, aren’t always justifiable.


There are a few problems that do warrant early treatment and retention. These include:

1. Cross bites causing the lower jaw to shift.

2. Space maintenance for early loss of a baby tooth or crowding.

3. Patients suffering psychologically or socially from an overbite or severely crooked
front teeth.

4. Total time in braces, retainers, and maintainers is less, so the cost is less.

5. Severe jaw imbalance.

In all these cases, full braces will be needed when the permanent teeth are fully erupted. Additional time and expense are warranted only due to the special nature of these problems.


Timing is everything. The goal of orthodontic treatment is beautiful teeth that last a lifetime. Achieving this goal in the least possible time will make the process of orthodontics as easy as possible.

We place children not quite ready for braces in our observation/supervision program to assess their readiness for braces. We monitor each child’s individual development to determine the best time to place braces to get the best result with the least intervention. Sometimes waiting is the best “treatment”.

Please feel free to contact the office if you have any further questions.



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