Many parents bring their 7-year-old children to our office for orthodontic consultations (also known as “orthodontic treatment” or “braces”) as their incisors begin to be replaced! Since the incisors are the first set of permanent teeth to replace the baby teeth, they always receive extra attention. Parents are often anxious if their child’s upper and lower incisors are crowded, have “buck teeth,” “bunions” or large gaps, and want to know if they need to start braces right away. Some believe that the sooner a problem is treated the better …… while others are influenced by other parents and children. While starting orthodontics early can treat some problems with tooth alignment in a timely manner, since all of a person’s permanent teeth do not erupt until age 12, starting children in braces at age seven or eight means taking too long to treat or receiving a second orthodontic treatment as a teenager. Doctors have long been controversial about such treatment options. On the one hand, some dental alignment problems need to be treated as early as possible and the timing of treatment should not be delayed; on the other hand, many children do not yet have good oral hygiene habits, and because the self-cleaning effect of saliva on teeth is reduced after wearing braces, wearing aligners too early can increase the risk of tooth decay and periodontal disease for children who cannot brush their teeth carefully So, when is the best time to start orthodontic treatment? Many studies have shown that when to start orthodontic treatment varies from person to person, taking into account the child’s own dental status, developmental timing, hygiene habits, and their psychological state. According to the American Association of Orthodontists, the average age of initiation of orthodontic treatment for adolescents is 12 years old, with treatment lasting 1-3 years, with a few children receiving Phase I treatment at age 7-9. William Proffit, a professor at the University of North Carolina at Chapel Hill School of Dentistry, conducted three large randomized clinical trials of children with class II bites (i.e., maxillary protrusion or mandibular recession, commonly known as “buck teeth”). The results found that early treatment did not help correct the Class II jaw. He concluded that “early treatment of Class II jaws has no significant effect, and parents not only have to pay more for their children’s visits, but this unhelpful premature treatment can be a burden on the child’s life.” He recommends that treatment in this category should be administered during the patient’s adolescence. On the other hand, early orthodontic treatment for Class III occlusion (i.e., retrusion of the upper jaw or protrusion of the lower jaw, commonly known as “retrognathism” or “diastasis”) is essential. One of the treatment options for this group of patients is to promote maxillary growth, which peaks between the ages of 7 and 9 years, so the best time to treat is before the age of 10. For most children with a Class I bite (i.e., children with a normal upper and lower jaw relationship), most orthodontic treatment should begin after the permanent teeth have fully erupted. If unattractive teeth lead to teasing and psychological shame at school, early treatment becomes necessary to make the child more acceptable to peers in social life. Early treatment is also necessary if a child has bad habits such as finger-allowing that cause front teeth to open and close, or if the lower jaw is habitually shifted due to narrowing of the upper jaw. In addition, while there are general dentists who can provide orthodontic treatment, parents need to know that “orthodontists are specialists who have completed a full dental education followed by two to three years of orthodontic training for the sole purpose of learning how to move teeth effectively.” The American Academy of Orthodontics recommends that parents have their children examined by a specialist-trained orthodontist up to and including age 7 in order to properly assess the optimal age for their child to begin orthodontic treatment. (1) Individualized treatment: Every child is different, so the timing of orthodontic treatment needs to vary from person to person; for example, girls develop early and mature psychologically, so they can follow medical advice well, so the treatment period can be advanced accordingly. (2) Weigh the pros and cons: analyze the benefits and cons of the treatment plan, including why treatment is needed now and whether the treatment will be lost if it is late. Will the child’s brushing habits be good enough to control tooth decay while wearing the aligners? Can the child comply with medical advice? And so on …… treatment only makes sense when the benefits far outweigh the disadvantages. (3) Improve the efficiency of treatment: starting treatment at the right age can shorten the treatment time, reduce the waste of resources, and achieve twice the result with half the effort. (4) Seek help from a specialist when conditions permit.