The Value of an Orthodontic Evaluation for Children

Ask the Experts by Dr. Craig Hadgis

Q: Our dentist hasn't yet said anything about orthodontics for my 6 year old. Does that mean he won't need it, or should I have him evaluated on our own?

A: I recommend evaluation for all children no later than 7 by an orthodontist. Although many people associate orthodontic treatment with young teens, most orthodontists can spot subtle problems with jaw growth even when "baby" teeth are present. Your child's teeth may appear straight, however, there could be a problem that only an orthodontist can detect.

I can't emphasize enough how important it is that parents understand the value of an orthodontic evaluation. By age 7, enough permanent teeth have arrived to evaluate how the teeth and jaws meet and work, and if the relationship affects a child's ability to bite, chew and speak effectively. Between the ages of 3-5 orthodontists can evaluate airway restrictions such as tonsil and adenoid problems that can affect sleep.

Parents should notify an orthodontist if there are psychosocial concerns or your child is being teased at school. Intervention is necessary to prevent mouth deforming habits such as thumb sucking, tongue thrusting, lip and nail biting.

A visit to the orthodontist can simply ease a parent's mind. The recommendation may be 'let's wait and see' while the face and jaws continue to grow. However, I may prefer to treat jaw problems early, giving the patient a better prognosis for improved function and aesthetics of the adult teeth. This can prevent or intercept more serious problems from developing, making treatment at a later age shorter and less complicated. In some early treatment cases results could be achieved that may not be possible once the face and jaws have finished growing.

If your child is older than 7 it is certainly not too late for an evaluation. Patients differ both in psychological development and treatment needs and can be treated appropriately.

Some conditions that indicate the need for an evaluation include:

  • narrow upper jaw
  • birth defects of the mouth- cleft lip and palate
  • mouth deforming habits- thumb sucking, tongue thrusting, lip and nail biting
  • early or late loss of baby teeth
  • difficulty in chewing or biting
  • mouth breathing
  • airway restrictions- identifying tonsil and adenoid problems
  • crowding, misplaced teeth
  • excessive gaps
  • jaws that shift or make sounds
  • skeletal cross-bites, growth disturbances, asymmetries and facial imbalance
  • biting the cheek or the roof of the mouth
  • teeth that meet abnormally, or don't meet at all
  • jaws that are too far forward or back
  • missing teeth or teeth not erupting
  • psychosocial concerns, subject to teasing
  • speech difficulties
  • sleep disturbance
  • earaches

Potential treatments include:

  • creating room for teeth
  • monitoring and guiding tooth eruption in a timely manner to encourage a more favorable position
  • early correction of jaw relationships
  • directing beneficial facial growth
  • correcting malocclusions: overbite, underbite, openbite and crossbite
  • protection for front teeth which can be prone to injury and for playing contact sports
  • create a more pleasing arrangement of teeth, lips and face
  • dietary and nutritional information
  • oral hygiene education and value of healthy living
  • improving self-confidence and enhance responsibility
  • providing scientific, realistic and helpful information for dental/orthodontic concerns and alternative options
  • build a relationship to alleviate apprehension or fear as we get to know patients

Dr. Craig Hadgis is a Diplomate of the American Board of Orthodontics, which only 1 in 3 orthodontists achieve. He earned his dental degree from University of Detroit Mercy and orthodontist specialty license from Jacksonville University in Florida. Dr. Craig Hadgis has been nominated by his peers by the Detroit Hour Magazine as Best Orthodontist and was elected to be the 2016-17 President of Detroit District Dental Society's Eastern Branch. Dr. Hadgis can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 313.264.1184. Hadgis Orthodontics is a member of The Family Center's Association of Professionals.

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