How Old Do You Need to Be to Start Braces?

The age to start orthodontics is dependent on the reason for treatment. There are two general categories of orthodontic treatment: Two-Phase Treatment (Phase I and Phase II) and Comprehensive Treatment. Orthodontic treatment includes braces, clear aligner systems like Invisalign®, or other intra-oral appliances.

In this article, you’ll learn:

• What is Two-Phase Treatment?
• What is Phase I Treatment and when does it start?
• What is Phase II Treatment and when does it start?
• Do all orthodontists recommend two phases of braces?
• What is Comprehensive Treatment and when does it start?
• Is orthodontic treatment effective for adults?

What is Two-Phase Treatment?

Two-Phase Treatment means that instead of one phase of orthodontic treatment once all of the permanent teeth are in, your child will have two rounds of treatment:

• Phase I- “Interceptive Treatment,” before all of the permanent teeth have erupted
• Phase II- After all of the permanent teeth have erupted

What is Phase I Treatment and when does it start?

The American Association of Orthodontists (AAO) recommends an initial orthodontic screening at the age of 7 years. While this may seem early to start bringing your child to the orthodontist, changes in the developing teeth and jaws should have regular monitoring. Most orthodontists are happy to provide an evaluation if you or your child’s dentist has concerns before age 7. Dental cleanings and check-ups are important, but they are not substitutes for an orthodontic evaluation.

Phase I usually occurs between 7-10 years, when there is a mix of permanent and baby teeth. Phase I treatment has specific goals like correcting a crossbite, making room for permanent teeth, or correcting severe jaw imbalance. This treatment usually takes one year or less and involves braces, clear aligners, and other appliances. After Phase I is complete, your orthodontist may provide a retainer for your child to wear to maintain progress.

If Phase I treatment is not recommended, annual visits are standard to monitor the eruption of your child’s tooth and jaw development.

What is Phase II Treatment and when does it start?

Phase II treatment is the final correction of the bite (how the teeth fit together when you bite down) and tooth position for optimal function, aesthetics, and health. Phase II treatment usually begins between 12-14 years after all permanent teeth erupt. This phase of treatment usually takes 12-24 months using braces or clear aligners.

Do all orthodontists recommend two phases of braces?

Because every doctor is a little different, you will likely get varying recommendations from each orthodontic consultation. Orthodontists usually fall into one of three categories for recommending early treatment:

• All young patients receive Phase I orthodontic treatment
• All patients wait until all of the permanent teeth have erupted before starting any treatment
• Phase I treatment is recommended if it can achieve a better outcome now than waiting until all the permanent teeth are in (this is Dr. Garfinkle’s preference)

If you’re unsure about your orthodontist’s recommendation, seek a second opinion to learn what options are available to you while also gaining a better understanding of what is best for your child.

What is Comprehensive Treatment and when does it start?

Comprehensive treatment is a single round of orthodontics that occurs after all of the permanent teeth have erupted. Like Phase II treatment, the goal is to correct the bite and tooth position for optimal function, esthetics, and health. Comprehensive treatment can start anytime after all the permanent teeth have erupted, around 12-14 years. Some orthodontists may recommend treatment before the second molars have erupted, but we have found that this generally leads to longer treatment times.

Is orthodontic treatment effective for adults?

Many people think orthodontic treatment is just for kids, but according to the AAO, 1 in 4 orthodontic patients are adults. Adults seek orthodontics to improve the alignment of their teeth, correction of their bite, or even in conjunction with jaw surgery to treat sleep apnea. Orthodontics is safe and effective for adults under the care of a trained Orthodontic Specialist, ideally one that is Board Certified. While there is no age limit for orthodontics, your doctor will evaluate your needs to see if clear aligners or braces will help you achieve your goals.

Teeth continue to move throughout our lives, so if you don’t like the appearance of your teeth, you can choose orthodontic treatment to improve your smile, or you can get a nighttime retainer to keep your teeth from shifting further.

The Takeaway

The AAO and Dr. Garfinkle recommend an orthodontic evaluation starting at seven years of age, with annual check-ups to evaluate tooth and jaw development. At Garfinkle Orthodontics, these visits are complimentary until your child begins treatment, giving you an excellent opportunity to gather information and consider the timing for orthodontics. Comprehensive treatment can begin anytime after all of the permanent teeth have erupted.

With photos, measurements, and a discussion with your orthodontist, you can learn if orthodontic treatment with braces or aligners would benefit you or your child. No referral is necessary, but you can ask your dentist for recommendations or search for a board-certified orthodontist on the AAO website.