Medically Reviewed by Dr. Laura Sharbash, DDS, FAGD, D.ABDSM on September 25, 2026
Most children do not need early orthodontic treatment, but some do benefit from it. Most orthodontic treatment starts in the teen years when all permanent teeth have come in and results are more predictable. However, some young children need early intervention, often called Phase One treatment, to guide jaw growth or correct a bite problem before it becomes harder to fix. An early evaluation does not necessarily mean orthodontics are needed right away. Instead, monitoring growth patterns helps identify the best time to start treatment, if it is needed at all.
The American Association of Orthodontists recommends that children have an orthodontic check-up by age 7, and it notes that not every early visit leads to treatment. At Newport Beach Dental Center, we keep an eye on bite and jaw development during your child’s routine dental visits, so we can help you decide when a closer orthodontic evaluation makes sense and what the next steps might look like.
What Causes Orthodontic Problems?
Some cases are a matter of genetics or inherited orthodontic issues, such as crowded teeth, excessive spacing, bad bites, or protruding teeth. Other cases may be due to injury, early or late loss of baby teeth, or habits like thumb sucking.
Long-term pacifier or thumb habits are among the most common habit-related causes, because steady pressure on the teeth and palate can change how they develop. Our article on how pacifier use affects a baby’s dental development covers when these habits become a concern. Breathing patterns can matter too, since chronic mouth breathing is associated with changes in how the jaws and palate grow.
Why Age 7 Is the Recommended Check-Up Age
By around age 7, most children have their first permanent molars and some permanent front teeth, while many baby teeth are still in place. This mix gives a clear view of how the jaws are growing and whether there is enough room for the adult teeth that are still coming in.
At this stage, the upper jaw is still developing, which is why certain problems are easier to address now than later. The AAO explains that early care can include widening a narrow upper jaw to relieve crowding, correcting a front crossbite before it worsens, or removing baby teeth strategically so permanent teeth come in in a better position. For many children, though, the right plan is simply to watch and re-check as they grow.
Evaluating the Need for Early Treatment
Some issues are easy to spot, and some developmental issues correct themselves as children grow into their preteen years. It helps to have a professional confirm whether your child’s oral development is on track or whether intervention would help. Some of the issues a dentist may evaluate include:
- Difficulty chewing or biting
- Thumb sucking after age five
- Mouth breathing
- Speech impediments
- Early or late loss of baby teeth
- Protruding teeth
- Shifting of the jaw when opening or closing (crossbite)
- Crowded front teeth
Dental X-rays are often part of this evaluation because they show permanent teeth that have not come in yet. Our guide on when children should have dental X-rays explains how imaging helps catch developing problems early.
What Is Phase One Treatment?
The goal of early treatment is to help your child’s jaw develop correctly so there is enough room for the permanent teeth. Partial braces, palatal expanders, space maintainers, or retainers can be used to create space and guide growth. In the right cases, these early methods can reduce the need for more involved treatment later and make a future round of orthodontics shorter or simpler.
Phase One treatment is usually shorter than comprehensive orthodontic treatment, and the exact length depends on the problem being corrected. Once it is complete, your child may wear a retainer to hold the progress in place while the remaining permanent teeth come in. Phase Two, if needed, typically begins after most of the permanent teeth have erupted.
How Two-Phase Treatment Unfolds
Every child’s timeline is different, but two-phase treatment generally follows the same sequence. The stages below show how the pieces fit together.
Step 1
Check-Up by Age 7
An evaluation of jaw growth, bite, and spacing while baby and permanent teeth are both present.
Step 2
Phase One, If Needed
Targeted treatment such as an expander or space maintainer to correct a specific growth or bite problem.
Step 3
Monitoring Period
A retainer may hold progress while the remaining permanent teeth come in, with periodic check-ins.
Step 4
Phase Two
Full braces or clear aligners to fine-tune tooth positions once most permanent teeth are in.
Not every child moves through all four steps. Many children only need the first and third, while others go straight to comprehensive treatment in their teens.
Phase Two Orthodontic Treatment
Once most of your child’s permanent teeth have erupted, Phase Two can begin. Many children who had Phase One treatment will also need a Phase Two, although it is often simpler because the earlier work created room and improved the bite. The second phase usually involves full braces or clear aligners, and progress is monitored regularly until the teeth reach their planned positions.
For teens who are ready for comprehensive treatment, clear aligners may be an option worth discussing, and our article on the benefits of clear aligners for teens and young adults walks through why many families consider them. After treatment is complete, a retainer is still needed to keep teeth from drifting back toward their original positions.
Simplify Orthodontics With Early Intervention
Orthodontics, like most other dental and medical services, works best when problems are caught early. Identifying a developing jaw or bite issue at the right time can help your child avoid more complex care in later years and may reduce the need for restorative or corrective procedures down the road.
Early treatment does not apply to every orthodontic problem, but it can help in certain cases. Braces and aligners have improved considerably over the past couple of decades, making them more comfortable and more effective. With proper planning, a child who needs early orthodontics may enjoy better self-confidence, healthier tooth and bite function, improved jaw alignment, and more stable results.
Schedule Your Child’s Evaluation at Newport Beach Dental Center
Dr. Laura Sharbash, DDS, FAGD, D.ABDSM, and our team pay close attention to how your child’s teeth, jaws, and airway are developing at every visit. Her training as a Fellow of the Academy of General Dentistry and a Diplomate of the American Board of Dental Sleep Medicine means bite development and breathing patterns such as mouth breathing are both part of the conversation.
If your child is approaching age 7 or you have noticed crowding, a crossbite, or a lingering thumb habit, we are happy to take a look and talk through next steps with you. Request an appointment to schedule your child’s visit.
Frequently Asked Questions About Early Orthodontic Treatment
At what age should my child first be checked for orthodontic problems?
The American Association of Orthodontists recommends an orthodontic check-up by age 7. At that age, a mix of baby and permanent teeth makes it easier to see how the jaws are growing and whether there will be enough room for adult teeth. Your child’s regular dentist can also flag concerns earlier if they notice them during routine visits.
Does every child need Phase One orthodontic treatment?
No. Most children do not need early treatment, and many early evaluations simply lead to periodic monitoring. Phase One is generally reserved for problems that are easier to correct while the jaw is still growing, such as a narrow upper jaw, a crossbite, or severe crowding.
What are signs my child might need early orthodontic treatment?
Common signs include crowded or protruding front teeth, a jaw that shifts to one side when closing, trouble chewing, a thumb or pacifier habit past age five, chronic mouth breathing, and baby teeth that fall out much earlier or later than usual. Any of these is a good reason to ask for an evaluation.
Will my child still need braces after Phase One?
Many children do need a second phase of treatment once most permanent teeth are in, but it is often shorter or simpler because the early treatment already created space or improved the bite. Some children only need a retainer and monitoring after Phase One.
Can children use clear aligners instead of braces?
Clear aligners are most often used for teens and adults once most permanent teeth have come in, and they can be an option for comprehensive treatment at that stage. Whether they suit a specific child depends on the type of bite problem, the teeth involved, and how consistently the aligners will be worn each day.
About the Author
Dr. Laura Sharbash, DDS, FAGD, D.ABDSM
General Dentist | Newport Beach Dental Center
Dr. Sharbash earned her DDS from the SUNY Buffalo School of Dental Medicine and brings more than 13 years of private practice experience to Newport Beach Dental Center. She is a Fellow of the Academy of General Dentistry and a Diplomate of the American Board of Dental Sleep Medicine, and she pays close attention to bite development and breathing patterns at every visit.
