Boy (11-13) smiling, portrait, close-up

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Teenagers seem to be the bread and butter of an orthodontics practice. The typical teen, wearing braces for a year or two to straighten crooked teeth, is a common sight in an orthodontist’s waiting room. Yet more and more pre-teens and children, some as young as 7, are beginning orthodontic treatment to avoid more serious problems with bite and tooth alignment down the road.

“You want to capture the child’s biggest growth potential and use it to your advantage,” says Dr. Larry Levens of Levens Orthodontics. “In other words, if somebody is growing in a way where one jaw is outgrowing the other, that growth trend will not change on its own—there’s not a catch-up type of growth. So you can alter the growth pattern and use that to help make the teeth fit together better, and the more growth they have left, the better that’s going to work.”

Dr. Jonathan Shanker, a St. Louis orthodontist, agrees that orthopedic concerns involving jaw growth and formation are primary reasons for young children to require orthodontic treatment. In children younger than 9, these concerns often center on malocclusion of the teeth, which involves improper positioning due to hereditary abnormalities in the jaw that affect the way the upper and lower teeth come together.

“The jaw—especially the upper jaw—is not fully formed in young patients, so you have a window of opportunity to change its position,” Shanker says. “If I want to widen somebody’s jaw and they’re 7 years old, I can do it with a retainer or with a little bar that’s glued on their teeth. Anything that provides just a little bit of widening pressure will cause the jaw to orthopedically widen because the upper jaw is made up of a few different bones that are not fully fused.”

By the early teen years, the bones are fusing together, and more pressure is needed to achieve the same results. Adults with fully fused jaws require surgery to widen the palate and correctly position the bones and teeth. “To do something involving orthopedic movement, usually the earlier, the better,” Shanker adds.

Both dentists note that younger patients also tend to tolerate orthodontic treatment better than teenagers or adults. “They don’t have all the different choices available to them that the older kids do,” Levens says of his pre-teen patients. “As kids get older, they realize that they can consider whether they want to do something or not, while younger kids typically do what we tell them to do and follow directions well. The younger kids don’t care as much about what they look like, and most of the time their friends think whatever it is they’ve gotten is pretty cool.”

Most young patients are referred for orthodontic assessment and treatment by a general dentist, although Shanker advises any parent who has questions or concerns about a child’s teeth or jaws to get a professional orthodontic opinion. “It can make a big difference in their future treatment, and sometimes they can even avoid jaw surgery,” he says.