When should children start orthodontic treatment? Everything about early-age correction

Many parents are truly worried when their child’s teeth are crooked or their jaw protrudes.

At the dental clinic It seems that orthodontic treatment may be neededHearing that makes parents feel rushed, wondering when their child should start orthodontic treatment and whether it is truly necessary.

Or it’s hard to know whether it’s okay to wait a little longer.

So this article is based on the explanation of Dr. Seungjun Park from Yeongjong International Dental Clinic, who is so well‑known in Yeongjong that he is even called the “Dental President.”

We provide an in‑depth overview of the timing of pediatric orthodontic treatment and the treatment approaches for each type.

🦷 When should children start orthodontic treatment?

1) Severe mandibular protrusion (underbite, Class III malocclusion)

This is a case where the lower jaw protrudes further than the upper jaw, and it is one of the most time‑sensitive conditions in pediatric orthodontics.

• Optimal timing: ages 7–8
• Reason: Only at this age can the growth direction of the jaw be modified
• If the timing is missed: Many cases require considering jaw surgery in adulthood

Children with an underbite tend to have strong forward jaw growth, so appliances are used to guide the growth direction downward.  

If this period is missed, it becomes difficult to control jawbone growth, making it the most critical golden time in pediatric orthodontics.

2) When the chin is too retruded (weak chin, Class II malocclusion)

This is a case where the upper jaw grows faster than the lower jaw.

• Optimal timing: around ages 10–12
• It’s less time‑critical than an underbite, but it is still important to treat it during the growth period.

In this case, a face mask or intraoral appliance must be worn for long periods, so cooperation from both the child and the caregiver is essential.  
Because the appliance must be worn consistently at home to be effective, the child’s cooperation plays a decisive role in the success of pediatric orthodontic treatment.

3) When the teeth are crooked (crowding, alignment issues)

This is one of the most common pediatric orthodontic cases.  

This happens when the front teeth come in crooked as they transition to permanent teeth, or when there isn’t enough space and crowding occurs.

But the important point is,  

It does not mean that pediatric orthodontic treatment is always necessary just because the teeth are crooked.

The necessary analytical factors are as follows.

• Jaw size
• Space for the teeth to erupt
• Future growth potential

By analyzing these three factors, we determine whether first‑phase orthodontic treatment is necessary or if second‑phase treatment during middle or high school will be sufficient.

4) When the spaces between the teeth are too wide

Parents also worry a lot when there is a wide gap between the front teeth.  
However, the timing of treatment varies depending on the cause, so a gap alone does not mean that pediatric orthodontic treatment should begin immediately.

🦷 Why is pediatric orthodontic treatment during the growth period important?

Growth‑phase orthodontic treatment goes beyond simply aligning the teeth evenly,  

It is the only period during which the growth direction of the jawbone itself can be modified.

Once a person becomes an adult, jawbone growth stops, so only the teeth can be moved, but  

Children’s jawbones are still growing, so orthodontic treatment that utilizes the growth plates is possible.

Especially in cases of underbite or a recessed chin, these conditions are closely related to the jawbone’s growth pattern,  

The growth period is essentially the most effective—and often the only—time for pediatric orthodontic treatment.

🦷 Phase 1 vs. Phase 2 Orthodontics (Core Concepts of Pediatric Orthodontic Treatment)

✔ Phase 1 Orthodontics (Mixed Dentition, Ages 7–11)

• A period when baby teeth and permanent teeth coexist
• Jaw growth can be controlled
• Space creation, habit correction, and jaw position adjustment
• It is not the stage for perfectly aligning the teeth.

✔ Phase 2 Orthodontics (Permanent Dentition, Ages 12–Growth Completion)

• After all permanent teeth have erupted
• The stage for precisely aligning the teeth
• Almost the same as adult orthodontic treatment

In other words,  

Phase 1 Orthodontics = Pediatric orthodontics that guide the direction of jaw growth  

Phase 2 Orthodontics = Full orthodontic treatment for precise tooth alignment

🦷 Jaw growth patterns are shaped by genetics and habits

One of the reasons pediatric orthodontics is necessary is because of daily habits.

Bad habits that affect jaw growth

• Thumb sucking / Finger sucking
• Tongue thrusting
• Mouth breathing
• Resting the chin on the hand
• Chewing on only one side

Mouth breathing, in particular, can cause the jaw to grow longer and narrower, making pediatric orthodontic treatment more challenging.

🦷 When a child loses a tooth, is a dental implant an option?

This is one of the most frequently asked questions from parents.

Conclusion: Dental implants should not be placed in children.

The reasons are as follows.

• A child’s jawbone is still in the growth phase.
• Because a dental implant fuses with the bone, it does not move as the child grows.
• It may interfere with normal growth or lead to abnormal positioning.

Therefore, in pediatric orthodontic treatment, instead of using implants,  

a space maintainer or a temporary bridge is used.

🦷 The golden time when a tooth is lost

Separate from pediatric orthodontic treatment, the proper response when a tooth is lost is also extremely important.

• Visit a dentist within two hours
• Store the tooth in milk, saline solution, or under the tongue
• Water is strictly prohibited (osmotic pressure can damage root cells)

Children often have strong healing ability, so replantation may still be possible even after a day  

It is best to store the tooth in milk and go to the dentist as soon as possible

🦷 Ways to prevent tooth loss

• Wear protective gear when riding bicycles or kickboards.
• Use a mouthguard during sports activities.
• Avoid jumping on the bed.
• Regular check‑ups every six months.

Custom mouthguards are especially helpful for highly active children.

🦷 Key points to check during regular dental check‑ups

To check whether your child needs orthodontic treatment, review the following points

• Is there enough space for the permanent teeth to come in
• Is the jawbone growing in the correct direction
• Are there mouth‑breathing or other harmful habits
• Has the baby tooth fallen out too early
• Presence of cavities
• Appropriateness of the timing for orthodontic treatment

Pediatric orthodontics is not just about aligning teeth; it is an important process that influences a child’s facial growth and lifelong dental health  

Problems related to jawbone growth are especially time‑sensitive, and missing the right period may require surgery in adulthood, so early diagnosis is extremely important

On the other hand, simple alignment issues can be evaluated through precise space analysis to determine whether first stage orthodontic treatment is needed, allowing unnecessary early treatment to be avoided  

When a child loses a tooth, implants should not be done, and it is important to store the tooth properly and bring it to the dentist within two hours

When parents understand this information, they can make much wiser decisions for their child’s dental health  

With regular checkups and proper habit management, a child’s teeth can grow healthy

Yeongjong International Dental Clinic website http://youngjongdental.com

🧾 F&A (Frequently Asked Questions about pediatric orthodontics)

Q1. My six year old’s front teeth are coming in crooked. Should we start pediatric orthodontic treatment right away

A. It is difficult to determine based on the alignment of the front teeth alone. We decide on first stage orthodontic treatment after space analysis

Q2. My child has an underbite and is ten years old Is it too late

A. Ages seven to eight are the most effective, but it cannot be said that it is too late. A professional evaluation is essential

Q3. My child has difficulty wearing the appliance properly Is pediatric orthodontic treatment still possible

A. Cooperation is very important in growth‑phase orthodontic treatment. Jaw growth correction especially requires wearing the appliance at home as well

Q4. My child’s baby tooth fell out too early Is that okay

A. Without a space maintainer, the permanent tooth is more likely to erupt crooked

Q5. When a tooth falls out can I put it in water

A. Water is strictly prohibited. The tooth must be stored in milk or saline solution