An Orthodontist's Comprehensive Guide to Braces for Children (2025)

Concerned parents in Singapore frequently ask dentists when their child should start wearing braces.

• Why does my child require braces?

• When should my child put on braces?

• Is there anything I can do to save my child from requiring braces?

In this article, I will answer all of your most common questions about braces in children.

When Should My Child Get Braces?

The American Association of Orthodontists recommends that your child see an orthodontist by the age of seven.

• Around the age of seven, your child's baby teeth will begin to be replaced with permanent teeth.

• During the checkup, an orthodontist can notice disruptions to:

  • Eruption of permanent teeth

  • Abnormal jaw growth

• This enables them to recommend early orthodontic treatment as needed.

Some Reasons Why Your Child May Need Braces

Your child may need braces for the following reasons:

1. An Impacted Tooth or Teeth

An "impacted" tooth is one that is unable to erupt correctly. Braces can be used to "fish" the tooth out to the proper position.

Figure 1: An X-ray of an impacted upper right central incisor in a 9-year-old child (highlighted with the arrow).

Figure 2: An un-erupted upper right central incisor. These require braces.

Figure 3: Braces have been used to extract the upper right central incisor.

Figure 4: The upper right central incisor has been successfully drawn out and into position.

2. Bite Difficulties (Cross-Bite, Deep Bite, and Open Bite)

When your child's teeth do not bite in the proper position, it can cause gum and bone damage, resulting in unsteady teeth.

• An open bite might also cause difficulties with speech and eating.

• While not all bites require immediate attention, some of these atypical bites may have long-term implications.

• An orthodontist may propose early intervention with partial or detachable braces if necessary.

Figure 5: A cross-bite between the upper right central incisor and the lower right central incisor.

Figure 6: A deep bite, in which the lower incisors bite on the upper gums.

Figure 7: An open bite in which the upper and lower front teeth do not connect.

3. Abnormal Jaw Growth (Small Lower or Upper Jaw)

• A small lower jaw may cause the upper teeth to protrude, rendering them more susceptible to injury.

• If irregular jaw growth is allowed to continue, your child may eventually need jaw surgery to improve the jaw connection.

• Early orthodontic therapy can be performed on a growing child in order to regulate jaw growth.

• In a child with a small lower jaw, we can employ detachable functional appliances to stimulate jaw growth during the pubertal period.

Figure 8: Before therapy, a child had a tiny lower jaw.

For a child with a small upper jaw, a facemask may be utilized to encourage upper jaw growth while restricting lower jaw growth.

Is There a Way to Keep My Child from Requiring Braces in the Future?

This is a common question I receive when I notify parents that their child's braces should not be started yet.

The answer is both no and yes.

There is nothing we can do to keep a child from getting braces. Crooked teeth are caused mostly by a lack of space.

Some parents may criticize their child for not brushing their teeth properly or not caring for their teeth.

Others will blame themselves for not getting their child to the dentist for an early extraction.

Even giving your child supplements (such as calcium pills) or having their baby's teeth pulled early will not help much. If your child's jaw is small, their teeth may still come out misaligned.

Interceptive or Early Therapy

Early therapy can help reduce the need for additional treatment before a child's permanent teeth fully emerge.

With braces, impacted teeth can be "fished" out.

Functional devices can be used to correct jaw postures and reduce abnormal jaw growth.

The effectiveness of interceptive treatment is ultimately determined by your child's growth and heredity.

• Example: If a person is genetically inclined to be short, no amount of skipping will make them taller.

• Similarly, if someone has the genes to be tall, they will grow tall regardless of restrictions.

Early treatment may be less beneficial depending on how your child's jaw grows, but it may help normalize jaw growth and ease future therapy.

Are There Situations in Which My Child Can Avoid Braces?

Yes. Sometimes, it is necessary to "wait and see" before proceeding with treatment.

An "ugly duckling" phase often begins between the ages of 7 and 9, when a child's baby's front teeth begin to fall out and permanent front teeth erupt. This causes visible gaps in their front teeth. Though it may appear unsightly, it is a completely natural phase and not a concern.

Your child is unlikely to be disturbed since most of their peers will go through the same experience.

If your child's permanent front teeth are crooked, I usually recommend waiting until the entire set of permanent teeth has emerged before recommending braces.

Correcting misaligned front teeth too early can cause the back teeth to become impacted or stopped from erupting. This merely moves an issue from one location to another without solving the problem.

In some cases of impacted teeth in children, I may choose to closely monitor whether the tooth will erupt naturally over time.

You'd be surprised how "smart" a tooth can be—it may sometimes find its own way out without the need for surgery or braces.