An early start: what growth can still correct
«Why take a child to an orthodontist at seven if the teeth are still changing?» — a perfectly reasonable question. The answer is that at this age the orthodontist looks less at the teeth than at the jaws. And jaws grow on a schedule we can neither postpone nor repeat.
Growth is a tool that works only once
Treating a child offers a resource an adult does not have: the jaws are still growing. An orthodontist can steer that growth — nudge it one way, restrain it another. It is called growth guidance, and it is the cheapest and least invasive tool in all of orthodontics.
The clearest example is the palatal suture. The upper jaw consists of two halves joined along the middle of the palate. In a child that suture is open, and an appliance can push the halves apart: bone fills the gap and the jaw becomes wider.
From roughly 13–15 the suture ossifies. After that the same result requires either very long treatment or surgical release of the suture in an operating theatre.
That is the point of an early start: we are not speeding treatment up, we are using a window that is about to close. The same narrow jaw at seven means a plate and a few months. At sixteen it is a different conversation, with different timescales and a different price.
What growth lets us do
Widen a narrow upper jaw. This frees space for permanent teeth that would otherwise erupt in a second row or outside the arch.
Correct a crossbite. When the upper back teeth close inside the lower ones, the lower jaw learns to shift sideways. The longer it lasts, the more asymmetrically the face grows.
Influence a Class II bite. When the lower jaw is small and set back, it can be stimulated with special appliances during the growth spurt. Later, what remains is braces with compromises, or orthognathic surgery.
Hold space. If a milk tooth is lost well ahead of time, neighbouring teeth drift into the gap. A simple space maintainer keeps it for the permanent tooth.
Remove the cause. Mouth breathing, tongue thrust, thumb sucking — all of these keep pressing on the teeth daily, and at an early age they are still easy to work with.
What growth can no longer fix after 13
Honestly about the limit. Once active growth is over, the orthodontist works with teeth alone — moving them within the bone that exists. The shape of the jaws can no longer be changed.
In practice this means:
Marked jaw narrowing requires surgical release of the suture, or a compromise: extracting selected teeth so the rest can align.
A significant jaw discrepancy — braces will align the teeth, but the profile and the way the jaws meet stay as they are. Full correction means orthognathic surgery.
Asymmetry that has settled in can only be partly corrected.
None of this means treatment at 16 or 30 is pointless — it is always worthwhile, and most of our adult patients get an excellent result. The toolkit simply narrows and the timescales grow.
When not to postpone
Some situations make «let's look again next year» poor advice. See an orthodontist soon if you notice:
A crossbite — the jaw shifts sideways when closing, the chin looks asymmetric.
Constant mouth breathing, sleeping with an open mouth, snoring.
A milk tooth lost well ahead of time — a back one especially.
A permanent tooth erupting in a second row while the milk tooth is not loose.
Thumb sucking after 4–5 years.
The child struggles to close the lips at rest, or the front teeth visibly protrude.
Clicking in the joint or difficulty opening the mouth.
The general benchmark orthodontists use: a first check-up at 6–9 years, once the first permanent incisors and molars are through. By then the direction of growth is visible.
An early visit usually ends with the word «observe»
This is worth saying plainly, because many parents avoid the check-up precisely for fear that something will be fitted straight away.
The reality is different. Most children leave the first appointment without any appliance. The doctor records the starting picture, takes photos and, if needed, an X-ray, and schedules a review in 6–12 months. Then simply watches how growth unfolds.
That is the purpose of an early visit: not to start treatment as soon as possible, but not to miss the moment when it is genuinely needed. The difference between «started in time» and «noticed late» is often the difference between a plate for a few months and full treatment for two years.
What happens at the appointment: we examine the bite and how the jaws meet, look at the shape of the palate, the tongue position and the way the child breathes, and assess whether there is enough room for the permanent teeth. An X-ray if required. Then we say honestly one of three things: act now, observe, or see another specialist first.
I trained separately in paediatric orthodontics; at the clinic my colleague Kseniia Tretiak and I share the paediatric appointments. An orthodontic consultation costs UAH 690: examination, bite diagnostics and a treatment plan.
Frequently asked questions
At what age should a child first see an orthodontist?
At 6–9 years, once the first permanent incisors and molars are through. By then the direction of jaw growth is visible. If there is mouth breathing or thumb sucking, come earlier — at 4–5.
Why go if the teeth are still milk teeth and will fall out anyway?
At this age the orthodontist looks not at the milk teeth but at the jaws: their width, how they meet, their symmetry. That is what growth can correct — and what it can no longer correct once growth is done.
Will an appliance be fitted straight away?
Usually not. Most children leave the first check-up under observation with a review in 6–12 months. An appliance is fitted when there is a specific reason for it.
What happens if we simply wait until 14?
Some problems will then need different means: instead of widening the jaw, extractions or surgery. Teeth can almost always be aligned; the shape of the jaws can no longer be changed.
What is a crossbite and why not wait with it?
It is when the upper back teeth close inside the lower ones and the jaw shifts sideways. The longer it lasts, the more asymmetrically the face grows — which is why an early start matters here.
A milk tooth was removed early. Is that a problem?
It can be: neighbouring teeth start drifting into the gap, and the permanent tooth later lacks room. A simple space maintainer is often enough — have it checked.
Does an early start mean braces will not be needed later?
Not always. The early phase works with growth and function; braces work with the exact position of each tooth. But after an early phase, brace treatment is usually shorter and without extractions.
How long does the early phase last?
Usually a few months of active appliance work plus a retention period. The doctor gives exact timing after an examination, since it depends on age and on what is being corrected.
How much is an orthodontic consultation?
An orthodontic consultation costs UAH 690: examination, bite diagnostics and a treatment plan. If X-rays are needed for planning, the doctor will say so at the appointment.
Orthodontic treatment for children and adults: brace systems, aligners, bite correction. Modern protocols, thorough diagnostics and individual planning at every stage.
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We will see whether there is still time to use growth — and whether anything needs doing at all right now. An orthodontic consultation costs UAH 690.
Or book by phone 067 478 88 78
Book your child's first check-up
We will see whether there is still time to use growth — and whether anything needs doing at all right now. An orthodontic consultation costs UAH 690.
Book now