Every child is unique, which means that each child come with his or her own unique set of dental and facial issues which should be evaluated, monitored over time or treated before becoming a larger issue. The American Association of Orthodontists recommends that a child have their first orthodontic exam around the age of 7.

While early treatment may not be necessary for every child, it is often good to make sure if he or she is developing properly and if there are any on-going problems (such as thumb sucking habits) which should be stopped. There are also certain malocclusions of the jaw which can only be addressed before the age of 10, and early intervention may spare a child from the need to undergo Orthognathic surgery at a later date.

In addition, it is a great opportunity for children to familiarize themselves with the clinical environment. When the time comes for the child start orthodontic treatment, they can be more comfortable and familiar.

Some Common Signs that Your Child Should be Evaluated

  • Continued finger sucking habit after age five
  • An overbite, underbite or where teeth simply do not fit together properly
  • The bottom jaw shifting when your child opens or closes his or her mouth (may be related to dental or skeletal crossbites or temporal mandibular joint (TMJ) issues)
  • Asymmetry of the face, especially the lower face where the teeth and jaws are located
  • Severely gapped or crowded front teeth between the ages of seven and eight
  • Not losing primary teeth according to age, or adult teeth growing in when the primary teeth are not loose
  • Heavy snoring and poor sleep quality
  • Speech impediment or a lisp

Common Children’s Treatment Options at Heart Orthodontics:


No treatment is needed at this time, and we will monitor the child’s facial and dental development every six to twelve months. Most kids fall into this category as we watch and wait to make sure growth is progressing normally. Based on your child’s current development, Dr. Li can also give you an idea about the timing at which they will need orthodontic treatment (if any).

These observation visits are extremely important for planning ahead and monitoring for any issues not expected in normal growth and developments. However, we don’t believe in charging for these visits, and if treatment is indicated, finances will be discussed at that time.

Phase I Limited Braces

This refers to limited, or interceptive treatment that involves a few brackets on a few key teeth to make space for incoming adult teeth, to close up big spaces, to correct single tooth crossbite etc. The main goal is to address conditions that could lead to harmful effects on the teeth, gums or bite. Typically, this phase lasts for four to six months and is followed by a retainer for nighttime wear.

Since Phase I limited braces are meant to target specific problems before all the adult teeth have erupted, it is usually followed by normal teenage / adult braces a few years later after a resting period. The benefit of Phase I treatment also includes making full treatment less invasive and shorter in duration.

Palate Expanders

An appliance that is cemented on the roof of mouth in order to slowly expand the jaws to eliminate crossbites and make room for teeth. Before a certain age, the use of these appliance usually do not lead to any discernable discomfort since the jaws have not yet completed their growth, which makes the timing very crucial.

Removable Appliances

Some of these appliances look similar to retainers but contain active components that are designed to treat specific problems. One such example that we often use is the KD appliance.

Space Maintainers

These are passive appliances, meaning they do not apply any pressure to the teeth. They are reserved for situations where primary teeth were lost or extracted prematurely before the adult teeth are ready to erupt. Without them, the body may close the primary teeth spaces by shifting the teeth adjacent to the space, thereby effectively leading to less space for the adult teeth someday, which may even cause those adult teeth to become impacted. In certain cases with mild crowding in the lower arch, use of space maintainers may allow for spontaneous resolution of the crowding and may help the child avoid extractions in the later orthodontic treatments. Examples of these include lower lingual arch and Nance appliance.