Why Do Orthodontists Sometimes Recommend Early Treatment? | Vista Orthodontics | Dr. Brad Santelli 

Many parents are surprised when an orthodontist recommends evaluating their child at age 7 or 8. After all, most of their child’s permanent teeth have not even come in yet.

Why would orthodontic treatment be considered so early?

The answer is that orthodontics involves much more than simply straightening teeth. It also involves evaluating how the upper and lower jaws are developing, how the teeth fit together, and whether certain problems should be addressed while a child is still growing.

Early orthodontic treatment, sometimes called interceptive orthodontics or Phase 1 treatment, can help correct specific developing problems before they become more complicated.

However, early treatment is not necessary for every child. Knowing when it can help and when it is better to wait is an important part of making an informed decision.

Why Is Age 7 an Important Time for an Orthodontic Evaluation?

The American Association of Orthodontists recommends that children receive their first orthodontic evaluation by age 7.

At this age, children typically have a combination of baby teeth and permanent teeth.

This mixed-dentition stage provides an orthodontist with an opportunity to evaluate:

• How permanent teeth are erupting.
• Whether there is sufficient space for incoming teeth.
• Whether the upper and lower jaws are developing properly.
• Whether the bite is balanced.
• Whether certain habits are affecting dental development.
• Whether early intervention may prevent or reduce future complications.

The purpose of an evaluation is not necessarily to start braces. In many cases, the best recommendation is simply to monitor the child’s development.

Five Reasons an Orthodontist May Recommend Early Treatment

1. Correcting a Crossbite

A crossbite occurs when the upper teeth bite inside the lower teeth instead of outside them.

Some children compensate for a crossbite by shifting their lower jaw to one side when closing their mouth.

If a crossbite is contributing to a functional jaw shift, early correction may help establish a more balanced bite and reduce the risk of uneven dental wear.

Depending on the child’s condition, treatment may involve a palatal expander or another orthodontic appliance.

2. Addressing Severe Crowding

Crowding occurs when there is not enough room for teeth to align properly.

In some children, the upper or lower jaw may not provide adequate space for permanent teeth.

Early orthodontic treatment may help manage available space, guide tooth eruption, or address certain jaw-width discrepancies.

However, not all crowding requires early treatment. Some children naturally experience changes in spacing as they grow and their permanent teeth erupt.

3. Correcting an Underbite

An underbite occurs when the lower front teeth extend in front of the upper front teeth.

This can be associated with differences in upper and lower jaw development.

In certain children, early treatment may help improve the relationship between the jaws while growth is still occurring.

Because some underbites have a significant skeletal component, early evaluation is particularly important. The appropriate treatment depends on the cause and severity of the problem.

4. Reducing the Risk of Injury to Protruding Front Teeth

Children whose upper front teeth protrude significantly may have an increased risk of dental injury.

This can be especially concerning for active children who participate in sports or other physical activities.

Early orthodontic treatment may help reposition protruding front teeth and reduce their exposure to accidental trauma.

5. Addressing Harmful Oral Habits

Certain childhood habits can influence the development of the teeth and jaws.

Examples include:

• Prolonged thumb-sucking.
• Persistent pacifier use beyond the typical developmental period.
• Tongue thrusting.
• Certain patterns of mouth breathing.

These habits do not affect every child in the same way. However, when they contribute to an open bite, protruding teeth, or other orthodontic concerns, early evaluation can help determine whether intervention is needed.

What Is the Difference Between Phase 1 and Phase 2 Orthodontic Treatment?

Early orthodontic treatment is often divided into two phases.

Phase 1: Early interceptive treatment

Phase 1 typically takes place while a child still has baby teeth and permanent teeth.

The goal is to address specific developing orthodontic problems, such as crossbites, jaw-width discrepancies, or significant protrusion of the front teeth.

Treatment may involve expanders, partial braces, or other appliances.

Phase 2: Comprehensive orthodontic treatment

Phase 2 generally takes place once most or all permanent teeth have erupted.

This phase focuses on aligning the teeth, correcting the overall bite, and achieving a healthy, functional, and attractive smile.

Treatment may involve traditional braces or clear aligners, depending on the patient’s needs.

Not every child who receives Phase 1 treatment will necessarily require Phase 2 treatment, although many will benefit from additional orthodontic care as their permanent teeth develop.

Does Early Orthodontic Treatment Prevent Braces Later?

This is one of the most common questions parents ask.

The answer is that early treatment does not guarantee that a child will avoid braces during their teenage years.

The primary purpose of Phase 1 treatment is to address specific problems during a favorable stage of growth and development.

In some cases, early treatment may simplify later orthodontic treatment, reduce certain complications, or improve the conditions under which permanent teeth erupt.

However, comprehensive orthodontic treatment may still be necessary once the remaining permanent teeth come in.

Parents should be cautious of any promise that early treatment will automatically eliminate the need for braces later.

Is Early Orthodontic Treatment Always Better?

No.

Timing is extremely important in orthodontics, and starting treatment too early when it is not necessary can result in additional appointments, longer overall treatment periods, and unnecessary expense.

Some orthodontic problems are best treated during childhood, while others are more appropriately addressed after permanent teeth have erupted.

An experienced orthodontist should evaluate each child individually and recommend treatment based on their dental development and specific needs.

Sometimes the best treatment plan is simply to wait and monitor.

What Are the Warning Signs That My Child May Need Early Orthodontic Treatment?

Parents should consider an orthodontic evaluation if they notice:

• Upper or lower teeth that do not meet properly.
• A lower jaw that appears to protrude.
• Upper front teeth that stick out significantly.
• Severe crowding or overlapping teeth.
• Difficulty biting or chewing.
• Teeth that do not seem to fit together correctly.
• A noticeable shift of the jaw when biting.
• Early or late loss of baby teeth.
• Persistent thumb-sucking or other oral habits.

Even when none of these signs are present, an orthodontic evaluation around age 7 is recommended.

The Importance of Choosing the Right Time for Treatment

Orthodontics is not simply about putting braces on teeth. It is about understanding how the teeth, jaws, and facial structures develop together.

Identifying certain problems early can create opportunities to guide development and improve a child’s long-term orthodontic outcome.

At Vista Orthodontics, our approach is to evaluate each child individually, explain any developing concerns to parents, and recommend treatment only when there is a clear reason to proceed.

Some children benefit from early treatment. Others are better served by periodic observation until they are older.

The goal is not to start treatment as early as possible. The goal is to start treatment at the right time.

If your child is approaching age 7 or you have concerns about their bite or developing smile, schedule an orthodontic evaluation with Vista Orthodontics.

Vista Orthodontics — The right treatment, at the right time, for a lifetime of healthy smiles.

About Dr. Brad Santelli

Dr. Brad Santelli is an award-winning, highly respected and renowned orthodontist in South Florida with more than 20 years of clinical experience. Throughout his career, he has helped create more than 25,000 beautiful smiles for patients throughout the region.

Dr. Santelli has consistently earned recognition for his expertise. His clinical experience, commitment to his patients, and dedication to the art and science of orthodontics have earned him numerous awards and professional distinctions, including:

• America’s Best Dentists National Consumer Advisory Board – “Best Orthodontist” — 2020, 2021, 2022, 2023, 2024, 2025 and 2026
• Top 1% Worldwide Diamond Invisalign Provider — 2008–2021
• Top Dentists, The Boca Raton Observer— 2020, 2021, and 2022
• “Top Orthodontist in Palm Beach,” Palm Beach Illustrated — 2020 and 2021
• Guide to America’s Top Dentists — 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, and 2017
• “Best Orthodontist,” The Guide to Florida— 2026

As Chief Clinical Director (CCD) of Vista Orthodontics, Dr. Santelli is dedicated to providing exceptional, personalized orthodontic care through advanced technology, modern techniques, and innovative treatment options. Patients at Vista Orthodontics benefit from customized treatment plans, including traditional metal braces, clear ceramic braces, gold braces and Invisalign clear aligner therapy, designed to achieve healthy, confident, and beautiful smiles that last a lifetime.