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The Straight Truth About Orthodontia for Kids

The Straight Truth About Orthodontia for Kids

By Wendi Aarons

Something you don’t realize when you first become a parent is how much of your daily existence will be taken up with concerns about your child’s mouth. First there’s the nursing and teething, then dental hygiene and loose teeth and the Tooth Fairy and finally, the granddaddy of them all—orthodontia. If you just involuntarily gasped and grabbed your wallet when you read that word, you know exactly what I’m talking about.

My boys are 11 and 13, and we’re already very well acquainted with our orthodontist. (And not just because he’ll probably buy a sports car after we’re done with our treatment.) Our doctor has thoroughly explained the boys’ tooth-straightening process to me along the way, but there are still a few things I wish I’d known before we began treatment. So if you’re just beginning the process, here is my handy guide to getting started:

What age should my child first visit the orthodontist?

The American Association of Orthodontists recommends children be screened around the age of seven. However, there’s also the school of thought that it’s okay to wait until kids are nine or ten and they have more of their adult teeth. Both of my boys first went at age nine, and that was at the recommendation of their dentist who saw potential issues with alignment, crowding, bite and jaw growth. My advice is to ask your dentist what they think, starting when your kids are six or seven.

OK, but what problems can I look for for myself?

Per our orthodontist: “If the child still has only baby teeth, the teeth should ideally be slightly spaced. Baby teeth that are have no spacing, or that already have some crowding, generally mean that the permanent teeth will also be crowded. Other indicators of early orthodontic problems include underbites and crossbites. An underbite is when the lower front teeth are in front of the upper front teeth. A crossbite is when the lower back teeth are on the outside of the upper back teeth. Both bite problems usually indicate a skeletal growth problem that might need to be corrected at an earlier age.”

In my experience, even if their baby teeth are gorgeous, it’s a whole new ball of wax once their adult teeth start to come in. We didn’t expect our oldest to have any issues since he didn’t ever suck his thumb or drink from a bottle, but he still wound up with an overbite that needs major correcting.

Why see an orthodontist if my kid’s teeth seem straight?

As mentioned above, crooked teeth aren’t the only reason orthodontia may be needed. In fact, there are a whole host of other reasons that may not be visible at all. Bite, including over and under and cross, crowding, too much space between teeth, and alignment are just a few of the issues that may need to be corrected before braces are even discussed. For example, my oldest son wore a removable “palatal expander” for 18 months to stop the tongue thrust that made his front teeth jut out. Doctors are eager to fix certain problems before puberty, while the jaw and mouth are still growing, because it’s harder when kids get bigger.

What will the first visit entail?

The doctor will examine your child’s mouth, and may also take X-rays, photos and a mold of their teeth. (This may take a few tries if your kid has a strong gag reflex like my oldest.) It’s important to mention any chewing issues, or if the jaw popping the child may have. The doctor will then say everything looks good, or recommend a treatment plan. And while it should be taken seriously, of course, the treatment plan also needs to be carefully considered because not every insurance plan covers more than one orthodontic issue.

What insurance issues should I be aware of?

If you have orthodontia insurance, good for you. Any bit helps when you’re looking at expenses in the thousands. (Full disclosure: My oldest’s braces are $5,500.) However, before you start any type of orthodontia—even a small retainer—take a good look at your insurance policy because some of them only cover a child’s treatment once. Friends of mine had a small device for their daughter paid for by insurance when she was nine. Now she’s 13 and needing more expensive braces, and it’s not covered because they already used their one payment. Check to see how much is covered, then carefully compare it to your child’s treatment plan.

You should also find out if there are any other limitations in your orthodontics insurance, such as age of the patient, maximum amount, deductibles etc.

What can we do if we don’t have orthodontic insurance?

There are certainly plenty of “low-cost dental plans” out there to use, but an internet search for them can prove to be a bit overwhelming. Plus, most of them look a little fishy, at least to me. Your best bet is to talk to your orthodontist’s office and see if they can recommend a plan. Chances are, they’ve worked with many of them and know which one is the best. Many practices will also let you make a down payment on the braces, then you can continue with monthly payments.

Should I wait until middle school? Why the rush?

When I was a kid, nobody had braces until they were at least 12 or 13. Now you see kids in grade school already wearing braces. This seems to be because some doctors don’t feel the need to wait until baby teeth are lost. In fact, many doctors will pull out teeth so they can get the process started early. If you’re okay with this, then go ahead. Our doctor wanted to wait until most of my oldest’s teeth fell out on their own before putting on braces, so he didn’t get them on until he was 13. This means that he’ll probably still be wearing them when he’s 16, but I feel okay with the decision. Again, talk to your doctor and if you don’t like what he/she is saying, either let them know or find someone else to handle your child’s needs.

Of course, I have plenty more to say about the actual devices, braces and incredible fun you’ll have repeatedly telling your kid that he can’t have popcorn for three or more years, but that will have to wait for my next post. If you have any of your own orthodontic advice, please feel free to share!



About the Author

Wendi Aarons

Wendi Aarons is an award-winning humor writer and blogger who lives in Austin, Texas with her husband and two sons. You can usually find her at

Wendi Aarons is an award-winning humor writer and blogger who lives in Austin, Texas with her husband and two sons. You can usually find her at Wendi Aarons, The Mouthy Housewives or starting fistfights near the 70% off rack at Target.

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  • S

    February 18, 2015 at 12:32 pm

    I started all this at.. 9? I think. I was i third grade. It started with te palate expander-and a key to turn which hurt like the dickens- i had baby teeth pulled, i had braces until hmm.. Tenth grade? Along the way came rubber bands, sometimes doubled and tripled. I had headgear that i had to wear at night. Once it was over i had two retainers, a metal and hard platic one, and a sort of invisiline sort of one. Lets just say, 5500 is the low end of the budget. My parents put in almost 40,000 into my mouth. And i had to get my wisdom teeth out at 14 in order to finish my plan or else id have to go through it for longer. Needless to say I’ve never been allowed to play contact sports because of it. And one of my biggest issues was the way my lips looked, mouth was too small braces were big. Took a long time to get used to it once they were off.

  • Trish

    February 18, 2015 at 2:30 pm

    I had a palate expander at age 5 due to a severe crossbite. It saved my parents thousands of dollars in additional dental work by correcting the problem early, and it was not painful. My husband got braces too early: around age 8 or 9, and then hit a growth spurt. His body grew so fast that one tooth in his upper jaw moved behind all the others, and now as an adult they would have to break his jaw to align his teeth. The reason I mention these two anecdotes is that I went to pediatric specialists (dentist and orthodontist). My husband did not. Kids’ growth is an important factor in orthodontic care. I think it is very important for parents to know that your general dentist may not have the training needed to deal with a growing mouth. It is worth finding someone who has trained to work with children.

    • Isabel Kallman

      Isabel Kallman

      February 18, 2015 at 3:15 pm

      Thank you for your stories and insight. Great point.

  • Sarah

    February 18, 2015 at 5:41 pm

    Here in Chicago, they’re putting braces on baby teeth on very young children, like age 7, and then off by 10.  The orthodontists claim that if you straighten baby teeth, the adult teeth will grow in correctly. I am waiting to see what happens with my friends’ children’s teeth (mine are still too young) because I would be pissed if I had to pay for braces twice over 6 years or something. If it’s true, then great.  Kids can avoid braces during puberty and awkward middle school years.

    There is also a trend toward “Hollywood” teeth, which is using braces to create a very wide smile. I am not a fan of this, as it looks unnatural and may not even create the best “bite” for the child.

  • Rachel

    February 18, 2015 at 7:30 pm

    One thing I’d consider before pursuing super-expensive orthodontia is to ALWAYS get a second opinion. My parents were told that I had a terrible overbite that desperately needed correction. We didn’t actually get it corrected at the time because we couldn’t afford it. My teeth are absolutely fine, and several dentists since have told me that orthodontia really would have been necessary for my relatively mild overbite. I’ve known many people with similar stories of orthodontists recommending overly cautious treatment, so get a second opinion and make an informed decision.

    • Wendi

      February 19, 2015 at 9:08 am

      Rachel, that is EXCELLENT advice. Thank you for mentioning it.

  • Sarah

    February 18, 2015 at 8:43 pm

     I just finished my second round of braces (at 27 years) due to a crossbite that either wasn’t fixed in my first round at 11-13 years or was caused due to my jaw continuing to grow after my first set of braces…. I would also recommend a second opinion. I grew up in a small city that only had one orthodontist, so who know if it’s his fault I needed braces again as an adult. This time, I drove 3 hours to a major centre to a highly recommended orthodontist. (Cost me $9000 this time)

    • Wendi

      February 19, 2015 at 9:09 am

      Sarah–so sorry to hear about this. But thank you for also recommending a second opinion.

  • Haley

    February 19, 2015 at 2:34 pm

    Along with the second opinion comments-if something doesn’t seem right or feel right, DON’T DO IT until you talk to someone else. I had braces once in middle school, once in high school, and now again at the age of 28. The first time, the orthodontist took them off too early (his words, not mine) so we had to put them back on. This time, he decided to pull a permanent tooth to help make room. We didn’t like the idea, but for some reason, we decided to trust him.  Problem being, I had a severe underbite, and pulling the tooth on the top only made this worse. Now, as a grown adult, I had to go have three more teeth pulled just to make fix the problems caused by the first. My parents still feel awful for putting me thru everything I’ve gone thru to fix my teeth. So, ask around. Find out who the best is. And if it doesn’t seem like a good idea, ask someone else. 

  • Elle

    February 19, 2015 at 9:30 pm

    About that gag reflex with the molds. Mine was HORRIBLE and it turned into a conditioned response thing every time I got in the dentist’s chair. I still have problems keeping dental films in my mouth. My solution was to take the first appointment in the morning, before I ate anything that day. It didn’t completely fix the problem, but it seemed to partially alleviate the discomfort by reducing the response to a mild dry heaving. Which was a huge improvement.

  • Sarah

    February 20, 2015 at 1:59 pm

    It’s frustrating that this post reads like an advertisement for dental services. I’m another person who had braces recommend, did nothing, and has perfectly fine, slightly crooked teeth. I often wonder if my bite is more stable and less prone to problems because it hasn’t been messed with.

    • Isabel Kallman

      Isabel Kallman

      February 20, 2015 at 7:42 pm

      Thanks for the feedback. I am the owner of this site and have never worn braces. It was never recommended to me because my teeth were straight (genetically lucky) as a child. They have since shifted a bit and now are not as straight but I would never consider orthodontia unless I was experiencing difficulty with my bite.

      We’ll take your feedback into consideration as we frame service-based articles in the future. Thank you.

  • Kit

    February 21, 2015 at 10:39 am

    Can I just add the advice to “Trust your instincts”? I believe there is a big difference between orthodontia for correcting bite problems and orthodontia that is cosmetic, but in my experience many orthodontists aren’t up front about this. Two of my siblings had moderate bite problems and truly needed braces. I, as the third child, had crooked bottom teeth in the front. My bite was fine. It was just not aesthetically ideal. The orthodontist insisted I needed several years of full braces to correct it. My lower middle class, uninsured parents balked. I didn’t get braces, my natural bite is better than what orthodontia was able to do with my siblings’ mouths, and nobody can even see the crooked teeth when I smile or talk. 

    Bottom line: if you are feeling pressured to act, or like “every kid MUST need braces so yours do too”, please find another provider. The need for orthodontia is not a given.

  • Kar

    March 4, 2015 at 6:06 pm

    All great advice. I had all my adult teeth very early (by Kindergarten/1st grade) so I started all of it really early and had it all off by 7th grade. However I didn’t wear my retainer the older I got and so as an adult I went to an orthodontist about just 1 tooth that started to move. He had done 1 of my sisters Orthodontist work. He wanted to completely redo my mouth and smile. Pull some teeth down to make all of them even and file the K9’s down so not to be as pointy. He had a standard smile he gave everyone. Everyone that came out of that office had the same wide smile and same looking teeth. I even told him I’m just looking for a retainer to stop this one tooth from continuing to move or if possible move it back I don’t want all that other stuff. My bite is fine, all my teeth are straight (except the one that very slightly has moved). He wouldn’t listen so needless to say I went with a different Dr. who listened to me and didn’t want to give me a cookie cutter smile. I wil be extra cautious with my kids when going to Orthodontists. I don’t want cookie cutter. I want straight with a healthy bite, something that is good for them and only them because everyone needs something a little different.