Why I’d Often Rather See Your Child Early Than Wait

There’s a common assumption that orthodontics is something you wait for — that you let all the adult teeth come through, see how things land, and only then think about braces. For a lot of children, that’s perfectly fine. But for some, waiting is a missed opportunity, and that’s what I want to talk about here.

This is the third piece in my series for the BDS Dental blog, and it’s about interceptive orthodontics — treating certain problems early, while a child still has some baby teeth, because doing so can make everything that follows simpler.

What “early” actually means

When I talk about treating early, I’m generally talking about children under the age of ten — before all the adult teeth have arrived. At that stage I’m not usually looking to do a full course of braces. I’m looking for specific issues that are better addressed now than later, where stepping in early either solves the problem outright or sets things up so the orthodontics down the line is shorter and easier.

In America, the guidance is that every child should see an orthodontist around the age of six, specifically to pick up issues early. In the UK we don’t really have that system — under the NHS it isn’t how things are set up. But in private practice, seeing children early is something we can and, in my view, should aspire to. The point isn’t to start treatment on every child who walks in. It’s to look, so that the small number who would genuinely benefit from early intervention don’t slip past the window where it helps most.

The kinds of problems worth catching early

A few examples make this concrete.

Protruding upper teeth. If a child’s top teeth are sticking out quite a lot, that’s something you can often begin to address earlier, rather than waiting years for all the adult teeth and then dealing with it. There’s also a practical reason to act: prominent front teeth carry a higher risk of being knocked and injured. Waiting can mean carrying that risk for longer than you need to.

Crossbites. Sometimes the top teeth bite inside the bottom teeth, which is the reverse of how they should meet. When there’s a crossbite — particularly one where the jaw shifts to one side to bite together — it tends to continue and entrench itself if left. That’s a good example of something you’d want to treat early, while it’s easier to correct.

Mild crowding. If a child is only very mildly crowded, a small amount of expansion at the right age can sometimes create enough room that you avoid having to remove teeth later on. That’s a meaningful difference — early, gentle intervention potentially saving a child from extractions down the line.

The thread running through all of these is the same question I ask myself: is there something we can treat now that will simplify the orthodontics later, or prevent a bigger problem from setting in?

The appliances I might use

Early treatment doesn’t mean a mouth full of metal. Depending on what we’re trying to achieve, the options range quite widely.

There are fixed appliances — the train-track style braces, in metal or ceramic — and these can be used on just a few teeth (sectional) rather than the whole arch when that’s all that’s needed. There are removable appliances, including upper removable braces and functional appliances, which have an upper and a lower part and are designed to help correct the bite by influencing how the jaws relate as a child grows. And increasingly there are aligners.

The right choice depends entirely on the child and the problem. That’s not me dodging the question — it’s the honest answer. Matching the appliance to the specific issue, the child’s age, and what they’ll realistically wear and tolerate is a large part of doing this well.

“But shouldn’t we just wait and see?”

Sometimes, yes. Plenty of children don’t need anything done early, and I’ll happily say so. Early treatment is not about treating everyone sooner — it’s about identifying the specific children for whom early action genuinely helps, and leaving the rest to be reviewed at the appropriate time.

That’s why an early assessment is so valuable even when it leads to no immediate treatment. The worst outcome is the child who would have benefited from a simple early intervention, but whose window quietly closed because nobody looked until all the adult teeth were already in. An early look costs very little and occasionally saves a great deal — sometimes a whole layer of more complex treatment, sometimes the loss of healthy teeth.

So if you’re wondering whether your child is too young to see an orthodontist, the answer is usually no. Seeing them isn’t a commitment to treatment. It’s simply making sure that if there’s something worth doing early, we don’t miss it.

In the next piece I’ll turn to the treatment patients ask me about more than any other — Invisalign — and explain, in plain terms, how it actually works and who it genuinely suits.

Dr Farnaz Motamedi is a specialist orthodontist at BDS Dental and an NHS consultant. To book an assessment for your child, contact the practice here.