An Orthodontist's Complete Guide To Braces For Children (2020)

When should my child put on braces?

What does my child need braces for?

Is there anything that can be done to prevent my child from needing braces?

I often receive these questions from concerned parents. In this guide, I answer all your most common questions about braces in children.

When should my child put on braces?

child smiling outdoors with braces

The American Association of Orthodontists recommends that you should bring your child to have a check-up with an orthodontist no later than age 7.

Your child's baby teeth will start to be replaced by their permanent teeth around the age of seven years old.

At the check-up, an orthodontist can detect disturbances to:

  • Eruption of permanent teeth
  • Abnormal jaw growth 

This allows them to recommend early brace treatment as necessary.

Some reasons for which your child may need braces

Your child may need braces for the following reasons:

1. Impacted tooth/teeth

When a tooth is obstructed from erupting properly, it is known as an "impacted" tooth (Fig. 1).

Braces may be used to tract or "fish" the tooth out to the correct position (Fig. 3).

Fig. 1 X-ray showing an impacted upper right central incisor in a 9y/o child as highlighted by the arrow
Fig. 1: X-ray of an impacted upper right central incisor in a 9y/o child.
(highlighted by the arrow)

Fig. 2 An un-erupted upper right central incisor. These need braces

Fig. 2 An un-erupted upper right central incisor. These need braces.

Fig. 3 Braces have been placed to tract the upper right central incisor out.

Fig. 3 Braces have been placed to tract the upper right central incisor out.

Fig. 4 Braces have successfully tracted the upper right central incisor out into position.

Fig. 4 The upper right central incisor has been successfully tracted out into position. 

2. Bite problems eg. Cross-bite, deep bite, open bite

Sometimes when your child's teeth are not biting in the correct position, there may be damage to the gums and bone, which results in shaky teeth.

An open bite may also cause problems with speech and eating.

While not all bite problems require immediate attention, some of these abnormal bites may have permanent consequences.

An orthodontist may recommend early intervention using partial braces or removable braces if necessary.

Fig. 5 Cross-bite: The upper right central incisor in cross-bite with the lower right central incisor.

Fig. 5 Cross-bite: The upper right central incisor in cross-bite with the lower right central incisor.

Fig. 6 Deep bite: where the lower incisors are biting on the upper gums.

Fig. 6 Deep bite: where the lower incisors are biting on the upper gums.

Fig. 7 An open bite where the upper and lower front teeth do not meet.

Fig. 7 An open bite where the upper and lower front teeth do not meet. 

3. Abnormal jaw growth e.g. small lower jaw or small upper jaw

A small lower jaw may cause the upper teeth to stick out, making them more prone to injury.

If abnormal jaw growth is allowed to progress, your child may require jaw surgery in future to improve the jaw relationship.

For a growing child, it is possible to carry out early orthodontic treatment that attempts to modify the growth of the jaws.

In a child with a small lower jaw, we can use removable functional applicances to encourage jaw growth during the pubertal age. (Fig. 8.1 to 8.3).

Fig. 8.1 Before treatment: a case of a small lower jaw in a child.

Fig. 8.1 Before treatment: a case of a small lower jaw in a child.

Fig. 8.2 During treatment: Braces and a functional appliance help to advance the lower jaw.

Fig. 8.2 During treatment: Braces and a functional appliance help to advance the lower jaw.

Fig. 8.3 After treatment: it's a success!

Fig. 8.3 After treatment: it's a success!

In a child with a small upper jaw, a facemask may be used to facilitate growth of the upper jaw and restrict further growth of the lower jaw. (Fig. 9.1 and 9.2).

Fig. 9.1 Before treatment: a case of a small upper jaw and a long lower jaw in a child.

Fig. 9.1 Before treatment: a case of a small upper jaw and a long lower jaw in a child.

Fig. 9.2 After treatment with a functional applicance (facemask) to advance the upper jaw and prevent excessive growth of the lower jaw.

Fig. 9.2 After treatment with a functional applicance (face mask) to advance the upper jaw and prevent excessive growth of the lower jaw.

Is there a way to prevent my child from needing braces in the future?

a teenager with braces

I get this question a lot when I inform parents that it’s not time for their child to start braces yet.

The answer: no and yes

There is nothing we can do to prevent a child from needing braces. It's all down to a matter of space: an inherent lack of space is the primary cause of crooked teeth.

Some parents may blame their child for not brushing their teeth well or not taking care of their teeth.

Others will blame themselves for not bringing their child to the dental clinic for an early extraction.

The truth is, it doesn't actually matter how well your child cleans or takes care of their teeth (though they should!).

Even giving your child supplements (such as calcium pills), or taking them to get their baby teeth extracted early does not help much. If your child has a small jaw, their teeth may still come out crooked.

There is nothing we can do to completely prevent a child from needing braces. However, it is possible to reduce the need for future treatment if interceptive or early treatment is used.

Interceptive/early treatment

Early treatment can help reduce the need for further treatment before a child's permanent teeth have fully erupted. Impacted teeth can be "fished" out with braces.

In addition, jaw positions can be corrected, and abnormal jaw growth can be reduced with the use of functional applicances.

It is important to note that the success of interceptive treatment ultimately depends on your child's growth and genetics. 

For instance:

  1. If someone is genetically predisposed to be short, no matter how much skipping they do, they will not grow taller than he or she is built to be.
  2. Conversely, if someone has the genes to be tall, even if we try to restrain them, they will still grow tall (though they will probably not reach their full height potential).

Therefore depending on the way your child's jaw grows, early treatment may not be as effective.

However, it may still be worth trying to normalise jaw growth using interceptive treatment. This can simplify future treatment or even save your child from going through jaw surgery in future.

Are there instances where my child can avoid braces?

a teenager girl wearing braces

Yes. Sometimes it is a case of "wait and see first" before treatment is advised.

An "ugly duckling" phase usually starts from age 7-9 when a child's baby front teeth start to fall out, and permanent front teeth erupt to take their place. This results in obvious spaces and gaps in their front teeth.

Although it may appear unsightly to parents, this is an absolutely normal phase and there is nothing to worry about. Your child is unlikely to be bothered as most of his friends will be going through the same thing!

If your child's permanent front teeth are crooked, I usually recommend waiting until their full set of permanent teeth have completely erupted before advising on braces treatment. This is because straightening crooked front teeth too early may cause the back teeth to be impacted or blocked from erupting. This only transfers a problem from one site to another, and doesn't help your child at all.

In some instances of impacted teeth in children, I may also choose to closely monitor if the tooth will erupt on its own over time. You’d be surprised how “smart” a tooth can be as it sometimes finds a way out on its own without needing any surgery or braces.

Get your child checked by the age of seven

It is recommended to bring your child to see an orthodontist early – no later than seven years old. This will allow the orthodontist to assess, diagnose, and recommend the best treatment options for your child.

Article contributed by:

Dr Elaine Tan
Department of Orthodontics
National Dental Centre Singapore


  • Written
  • Updated
  • Viewed23,643 times
Medically reviewed by National Dental Centre on 27/02/2018.
Read This Next
An Orthodontist's Complete Guide To Invisalign In Singapore (2020)

As an orthodontist over the past ten years, I’ve seen many Singaporeans with misconceptions about Invisalign and clear aligner treatment.

This guide tell will you all you need to know about Invisalign in Singapore, including perennial favourites such as:

  • How much you can expect to pay for Invisalign treatment in Singapore
  • The different types of Invisalign treatments available 
  • My opinion on the key differences between Invisalign and traditional braces (as someone who still uses both on a regular basis)
Your Child's Crooked Baby Teeth Might Lead To Damage In Their Adult Teeth! Singapore National Dental Centre Tells Us Why

In his/her early years, your child’s physical attributes will go through significant changes. One of the more prominent change would definitely be their teeth.

Dental issues might cause them a lot of pain and agony, but there are definitely ways to keep them under control. 

Dr Elaine Tan, an experienced orthodontist from Singapore's National Dental Centre, has had plenty of experience with painful orthodontic problems and dental abnormalities in children.

She was featured on DxD Sessions and shed some light on concerns regarding early braces treatment in children. Here are some key takeaways.

What Is Orthognathic Surgery And Who Needs It? Here's What You Should Know

One of the main reasons people seek orthodontic or braces treatment is to improve their bite. For some, the cause of their bite problems lies beneath their teeth, in the jaw bones.

The word “orthognathic” means “pertaining to the normal relationship of the jaws”.

When there is disharmony in the way the jaws sit with respect to each other, orthognathic surgery is advised to achieve normal alignment of the jaws.

Dr Priscilla Lu, an Associate Consultant Orthodontist, from National Dental Centre Singapore explains. 

DxD is proud to partner with National Dental to raise awareness about the importance of good oral health. To learn more about oral health and healthcare, head down to the National Dental Centre's public forum on dental care on 23 March 2019 to find out more.

What's Bimaxillary Protrusion And How To Fix It?

An individual's dental structure can often determine the appearance of his or her face. Many people are affected by visible protrusions derived either from the jaws, incisors or other components of the lower facial structure. Due to this, there may frequently be concerns among patients regarding how exactly they can manage such structural inconsistencies.

Dr Priscilla Lu is an experienced orthodontist, specialising in dental issues faced by numerous patients. In a DoctorxDentist post, she focused on concerns and treatments involved in managing bimaxillary protrusion, a condition that she helps patients deal with. Here's what she had to say.

Understanding Dental Bites: Singapore Orthodontist Gives You Something to Chew On

A dental bite refers to how your upper and lower teeth fit together when the mouth is closed. The definition of a healthy bite is when:

  • Your upper teeth fit a little bit over your lower teeth
  • The points of your molars fit the grooves of the opposite molar

In this article, I will be focusing on the 3 most common bite problems and how they differ from one another among other things to take note of!

Read more to find out!

Not the answer you're looking for? Browse other answers tagged Orthodontics, Children’s Health, Paediatric Dentistry or ask your own question now FOR FREE.

Request Quotes From Doctors

Based on your requirements, we will recommend up to 5 expert medical doctors.

Get Treatment Quotes
Related Questions
Thanks for your question! The cost of MBrace aligners will differ from clinic to clinic. Some clinics will tailor a cost according to your treatment plan, whereas others will have a package price. Usually if you’ve had braces in the past ... Read Full Answer
from your question, I assume that you're referring to getting Porcelain Veneers in a Smile Makeover procedure. Filing your teeth down is an irreversible procedure and should not be taken lightly. I am glad you did your homework to ... Read Full Answer
Yes it is definitely possible to address your dental needs!  Orthodontic treatment whether via metal / ceramic braces or clear aligners such as Invisalign can help to straighten out your teeth, correct open and under bites.  Braces ... Read Full Answer
Hi Anne-Marie Peters, Veneers are ultra-thin shells of material,which may be made of ceramic (porcelain) or a composite resin, that are bonded to the front of teeth. This procedure requires little or no anesthesia and may be an ideal choice for ... Read Full Answer
Thanks for the question. I always ask my patients how they are feeling after the jaw surgery during our review sessions. The general feedback is that some discomfort is felt but overall, it is bearable. This is possible because there are ... Read Full Answer
Thanks for the D2D. Yes, you will need to be hospitalised for at least a night after your jaw surgery. The exact duration of your stay depends on the extent of surgery and your personal speed of recovery. In most cases, patients tend to be ... Read Full Answer

"Dentist with an interest in comprehensive dentistry."

Adult teeth can develop in abnormal positions within the bone even if the baby teeth have exfoliated (dropped out) in time. There is NO WAY for this to be controlled.  A panoramic xray that can visualize the developing adult teeth and their ... Read Full Answer
Thank you for your question and for including pictures of your smile. It appears to me that you may have had prior braces treatment with conventional braces and some of the teeth may have shifted such as the lower front teeth and the upper ... Read Full Answer
Protruding front teeth is a common condition that brings individuals to seek orthodontic treatment. Orthodontic treatment is the best way of adjusting the position of teeth as natural as possible to correct the protruding front teeth. This can ... Read Full Answer
A single jaw surgery means only one jaw is manipulated during the surgery,this could be either the upper jaw (maxilla), or the lower jaw (mandible).While a double jaw surgery involves both the upper and lower jaw. The indication for either a ... Read Full Answer