It used to be that braces were a rite of passage for many adolescents. But in recent years, seeing an orthodontist has become common in children as young as six or seven.

Orthodontia is the practice of straightening teeth and correcting misaligned jaws, such as a crossbite (bottom teeth shifted to the side, forward or backward), overbite (upper teeth protrude over lower teeth), underbite (lower teeth protrude beneath upper teeth), or an open bite (few upper and lower teeth make contact with each other). Other signs that your child may need braces include crowded or overlapping teeth, finger- or thumb-sucking and wide spacing between teeth.

Recent advances have made it possible to treat younger children whose jaws haven’t finished growing. Dr. Shervin Abbaszadeh, an orthodontist in Toronto, says “Many orthodontic problems are easier to correct if detected early, as opposed to waiting until the jaw’s growth has slowed. Early treatment may mean a patient will avoid surgery or other more serious corrections later in life.”

In most cases, dentists refer parents to an orthodontist when they notice a potential problem in the child’s mouth, but a referral is not necessary.  Children are brought in mainly with types of malocclusion or teeth misalignment, says Abbaszadeh, noting some of the most common problems he sees are crossbites and overbites.

As a part of the process to find out what the treatment should be, an orthodontist makes a mold of the teeth by having the child sink his or her teeth into a dough-like substance. This mold hardens and is reviewed for any concerns with the structure.

An orthodontist does more than apply braces, especially with younger children. “Sometimes, we direct the dentist to remove teeth that are not growing properly or are in the way of other teeth growth,” says Abbaszadeh, but other times, they will recommend appliances such as a palatal expander (installed to widen the upper jaw) or a lingual arch (a metal device that connects two molars, either both in the lower or upper teeth arch).

These appliances can be worn anywhere from a few months to several years. Sometimes, it is only necessary for the child to use the less intensive device, while other times, it is setting the place of where braces will be later on in the child’s life.

The time and money is worth it to start orthodontic care early, according to Abbaszadeh. “It is better to start fixing issues now because if your child’s teeth continue to move out of place and grow incorrectly, it could affect his or her future dental health.”

Some advantages of early intervention:

  • avoiding tooth extractions
  • preserving tooth health
  • possibly avoiding braces
  • possibly making the braces experience easier and shorter

Some disadvantages of early intervention:

  • cost (it may not be less in the long run)
  • maturity of child to handle oral hygiene (braces and oral appliances don’t mix with hard, sticky, sugary foods and require excellent oral hygiene and compliance)

Dentist vs. orthodontist: What’s the difference?

The Canadian Dental Association requires orthodontists to have a university degree from a dental school, followed by at least two years of post-doctoral advanced specialty training in orthodontics in an accredited program. To find a specialist in your area, visit the Canadian Association of Orthodontists website at

cao-aco.org.

Originally published in May 2011.