An early orthodontic examination can be a valuable preventive measure in controlling dental and skeletal irregularities in a growing child. This may involve early treatment and management of a patient’s skeletal growth before most of the permanent teeth have erupted or simple interceptive treatment to control harmful habits. In many patients, proper treatment timing can achieve results that are not easily attained once the face and jaws have finished growing.


There is no one answer to this question because each orthodontic problem determines its own best starting time in terms of improvement that can be achieved with the least time and expense. For this reason, the American Association of Orthodontists (AAO) recommends that the proper age for a child’s first visit to the orthodontist is 7 years or even earlier if a problem is noted by the parents, family dentist, or physician. However, don’t assume that treatment will always begin immediately after a first examination. Dr. Sherman and Dr. Balhoff may simply want to check your child periodically while the permanent teeth erupt and the jaws and face continue to grow. In this way, the timing of treatment can be correlated with the best skeletal, dental, and psychological maturation level for each individual.



This age of development includes the children in the primary dentition, “baby teeth,” or until the eruption of the permanent incisors (front teeth) and first molars. At this young age, severity of the problem will dictate the necessary treatment.

Preventive treatment, such as space maintenance, in a patient with premature tooth loss (due to trauma or dental diseases) may be required. Controlling harmful habits, such as finger or thumb sucking, is often best done before the eruption of the permanent teeth, depending on the child’s willingness to stop. In addition, a child who breathes primarily through the mouth should be evaluated for a restricted nasal air flow.  This is because chronic mouth breathing can possibly lead to future developmental skeletal problems.

As a general rule, the treatment during this age period is kept simple since the child has a limited understanding of the problem and limited ability to comply with the prescribed treatment.



This age of development following the eruption of the permanent incisors (front teeth) and first permanent molars (six year molars), is commonly referred to as the “mixed dentition stage.” This age represents an excellent time for the correction of dental and skeletal problems because:

  • During this time, sixteen permanent teeth will erupt and guidance of this eruption can facilitate the correction of many malocclusions.

  • Several skeletal disharmonies may require Dr. Sherman and Dr. Balhoff to have as much control as possible over the direction and magnitude of the facial growth pattern.

  • Psychological development, understanding of treatment goals and patient cooperation is most improved.

Problems that are commonly treated during this stage of development include:

  • Over-bites (lower jaw is behind upper jaw)

  • Under-bites (lower jaw is in front of upper jaw)

  • Open-bites (the anterior teeth fail to meet)

  • Cross-bites (the upper teeth are inside the lower teeth)

Other problems that can be treated during this time period are prolonged thumb and finger sucking habits, abnormal swallowing habits, mouth breathing, excessive tooth crowding and jaws that tend to click and pop.

AGES 12- 16


This stage of development constitutes the majority of orthodontic patients treated in the country. There are two primary reasons:

  • The patients in this age group are undergoing pubescent growth, and this represents an excellent time for correction of most mild skeletal and dental problems.

  • The permanent dentition is now present, and the orthodontist has control over the development of the final occlusion. Normal pubescent ages for females are between the ages of 10 to 14 and between the ages of 11 and 16 for males.


Dentofacial Orthopedics is the process of normalizing the growth of a patient’s bone structure and repairing any imbalances of the face and jaws. This process often involves a two-phase treatment and often begins when the patient is around 7 or 8 years old.

Dentofacial Orthopedics for Children

Children are often the best candidates for receiving dentofacial orthopedic therapy. Beginning at a young age, your orthodontist will examine and monitor your child’s growth to determine when treatment starting treatment will be most effective. If your child begins orthodontic treatment before all adult teeth have erupted, it is known as phase-one treatment. During phase-one treatment, your orthodontist will use treatments designed to correct your child’s jaw growth and make sure that the jaw bone is properly aligned before beginning the second phase of treatment, which usually involves braces to straighten the teeth.