Early Orthodontic Treatment: Why the Australian Society of Orthodontists Recommends Age 7

Here in Claremont, parents often arrive at our practice a little surprised that we want to see their seven-year-old. Their child still has baby teeth. Braces seem like a teenage milestone, not something for primary school. So why age 7?

The Australian Society of Orthodontists, alongside orthodontic bodies across the world, recommends a first orthodontic assessment by age 7. This article explains the clinical reasoning behind that recommendation, what early treatment actually involves, and how to know whether your child is a candidate for it.

Why age 7 is the right window

At age 7, most children have their first permanent molars and their upper and lower front incisors. This specific mix of baby and adult teeth gives an orthodontist a clear picture of how the adult dentition is developing — without waiting for all baby teeth to fall out.

By this age, we can assess:

• Whether there is enough space for the adult teeth still waiting to erupt
• How the upper and lower jaws relate to each other — are they growing proportionally, or is one getting ahead of the other?
• Whether any adult teeth are blocked or impacted, changing the eruption sequence in a way that will create problems later
• Whether a crossbite is developing, where upper teeth sit inside lower teeth — something that can cause jaw shifting if left untreated

The key insight is that some problems are time-sensitive. The upper jaw, for instance, is made of two halves joined by a suture down the middle. In a younger child, this suture can be gently separated and widened using a palatal expander. By mid-adolescence, the suture begins to fuse more completely. By the late teens or early twenties, expansion without surgery becomes difficult or impossible.

An assessment at 7 does not commit your child to treatment. It simply identifies whether a problem exists, and whether there is a window — now or later — when addressing it would be most effective.

What the assessment involves

A first assessment at our practice on Stirling Highway is straightforward. Families from Christ Church Grammar School across the road, and from schools like MLC, Scotch College, PLC, and John XXIII College, regularly fit it into the school run — we are right off Stirling Highway, and the appointment itself is calm and non-invasive.

Dr Denize examines the teeth and bite, assesses jaw alignment, and typically takes an OPG (a panoramic dental X-ray) to see the position of all unerupted adult teeth. This tells us not just how many teeth are there, but whether they are developing in the right direction, in the right order, and with enough room.

In the majority of cases, the result is reassurance: everything looks fine, come back in 12 to 18 months and we will check how things are progressing. No treatment, no pressure. If something needs attention, Dr Denize will explain what it is, why it matters, and what the options are — clearly, without creating urgency that is not warranted.

What early treatment can address

Narrow upper jaw (palate expansion)

A narrow upper jaw is one of the most common reasons for early intervention. When the upper jaw is too narrow relative to the lower, the back teeth on one or both sides may bite inside the lower teeth — a crossbite. The lower jaw often shifts to one side to compensate, which can lead to asymmetric jaw growth if left uncorrected.

A palatal expander is a fixed appliance that gradually widens the upper jaw by putting gentle pressure on the growth suture. Treatment typically takes 6 to 12 months. The earlier this is done, the more predictable and straightforward the correction. Families from Nedlands, Dalkeith, and Cottesloe who have children with this issue often find that early correction simplifies or shortens the braces treatment that follows in the teenage years.

Crossbite correction

A crossbite can involve the front teeth, the back teeth, or both. When the front upper teeth sit behind the lower front teeth (an anterior crossbite), the lower jaw may be forced forward, affecting how the face grows. When the back teeth are in crossbite, the jaw shifts sideways.

Correcting crossbites during the growing years — when the jaw bones are still malleable — is considerably simpler than addressing them after growth is complete.

Space management

If a baby tooth is lost early due to decay or trauma, the teeth on either side can drift into the gap. This takes up space that the incoming adult tooth needs. A space maintainer — a simple fixed or removable appliance — holds the space open until the adult tooth is ready to erupt. This is a minor early intervention that can prevent the need for extractions or significant space-regaining later.

Managing impacted teeth

Occasionally, the eruption path of an adult tooth is blocked — by a baby tooth that has not fallen out, by a neighbouring tooth crowding its path, or simply by a lack of space. Catching impacted teeth early, before they become firmly lodged in the wrong position, allows simpler interventions: removing the blocking baby tooth, creating space, or guiding the tooth into position.

Addressing prolonged habits

Prolonged thumb sucking or dummy use past age 5 can push the upper front teeth forward, prevent the front teeth from meeting (open bite), and narrow the upper jaw. Orthodontic appliances can help break these habits and prevent the dental effects from becoming severe. For active kids at Freshwater Bay or along the Swan River on weekends, protecting the front teeth from excessive protrusion matters practically as well.

What Phase 1 treatment does not do

It is worth being clear about this, because some marketing around early orthodontics overstates what it delivers.

Phase 1 treatment is not comprehensive orthodontic treatment. It uses simple appliances to address one specific developing problem. The child will almost certainly still have some crowding, spacing, or bite issues that require full braces or clear aligners once all adult teeth have erupted — typically in the early teenage years.

What Phase 1 does achieve is one or more of the following:

• Prevents a problem from getting worse — a crossbite caught at 8 is simpler to correct than one caught at 14
• Creates the conditions for better comprehensive treatment — widening a narrow jaw makes it easier to align the teeth into the additional space that creates
• Avoids more invasive treatment — in some cases, early intervention means jaw surgery in adulthood is no longer necessary
• May shorten or simplify later treatment — when the jaw is in better shape going into the teenage years, comprehensive braces may take less time

We will always be transparent at our assessment about whether we expect your child to need further treatment after Phase 1. This is not a scenario we hide.

Monitoring vs treating: the most common outcome

For most children seen at age 7, the right course of action is monitoring — not treatment. We note what we see, take records, and schedule a review in 12 to 18 months to track how things are developing.

This ongoing monitoring is itself valuable. Problems do not always announce themselves suddenly. Watching a developing dentition over time lets us intervene at the exactly the right moment — not too early, not too late.

Parents across Perth’s western suburbs from Subiaco, Mosman Park, Peppermint Grove, and Swanbourne find it reassuring to know that the first orthodontic visit is not a commitment to treatment. It is a commitment to understanding what is happening and having a plan — whether that plan is to monitor, to intervene now, or to intervene later.

The cost argument for early assessment

One concern parents raise is cost. Bringing a child in for an orthodontic assessment, potentially for Phase 1 treatment, and then paying for comprehensive treatment as a teenager can feel like two courses of treatment where one might have done.

This is worth examining honestly. In some cases — those where early treatment does not simplify or shorten later treatment — it is fair to weigh this up. Dr Denize will tell you honestly whether the expected benefit of early intervention justifies the cost and the child’s time.

In cases where early treatment does make a meaningful difference, the calculus shifts. A child who avoids jaw surgery in adulthood, or who completes comprehensive braces in 12 months rather than 24 months because the jaw was already in good shape, will find that Phase 1 more than paid for itself.

There is also an element of practicality. Jaw problems that are caught at age 8 and corrected with a palatal expander and some simple appliances do not require the same resources as the same problems addressed at 17 — when surgery may be the only option.

How to book an early orthodontic assessment in Perth

You do not necessarily need a referral from your dentist to bring your child to see us, though many dentists do refer when they spot developing issues at check-ups. Children at around age 7 are welcome for an assessment whether their dentist has raised concerns or not.

At our practice at 7/355 Stirling Highway in Claremont — right across from Christ Church Grammar School, and just a short walk from Claremont Quarter — Dr Denize and the team see families from across Perth’s western suburbs. The initial assessment is designed to be comfortable for the child and informative for the parents.

Take our free 3-minute assessment at claremontorthodontics.com.au/assessment or call (08) 6288 7188 to book a consultation.

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Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.