Home / My Blog / Early Orthodontic Treatment And Your Orthodontist

Why should parents consider early orthodontic treatment for their children? Well, in the past, it was traditional for an orthodontist to only start orthodontic treatment on a child in early adolescence. This is when most of the baby (or primary) teeth have been lost, and most of the adult (or permanent) teeth have erupted.

But over the years, that’s changed to a degree. Early orthodontic treatment is now more common, and many dentists and orthodontists are working with children as young as seven years of age. Some orthodontists are assessing and treating children even younger than this.

early orthodontic treatment

As a myofunctional therapist, I’m fully supportive of early orthodontic treatment and intervention where necessary. Myofunctional therapy deals extensively with the airway, and one of the main reasons for adults and children to have a compromised airway is sub-optimal craniofacial growth.

Changing The Shape Of The Face And Jaws

When the face and jaws don’t develop correctly during childhood, the end result will be a longer, narrower face, with a narrow palate, and limited forward facial development. This can lead to crowding of the teeth, which is where the orthodontist usually comes in – to straighten them.

But there’s a much bigger issue with this kind of facial development than crooked teeth. A child with poor craniofacial development is also at higher risk for a compromised airway. This means they’re more likely to develop other health problems.

This quote is from an article titled Guiding Atypical Facial Growth Back to Normal Part 2: Causative Factors, Patient Assessment, and Treatment Planning by Dr. Steve Galella et al. It makes the case for early intervention in orthodontic treatment very clear:

“It has been well-documented that the most common factors associated with atypical facial growth involve the airway, which when compromised, leads to mouth breathing and associated aberrant tongue function.

The most common changes include downward and backward rotation of the mandible, deficient nasomaxillary complex, a vertical growth pattern, posterior displacement of the TMJ, narrow maxillary arch, dental malocclusions, and dental crowding. By the time the second molars erupt, approximately 90% of facial growth is complete. It is imperative that clinicians recognize, diagnose, and begin treatment as early as possible when facial growth deviates from normal.” 

I recently interviewed Dr. Derek Mahony about his upcoming research study covering over 4,600 young children. In the interview, he points out that when he was first trained in orthodontics, it was totally normal to only start braces when children had all their adult teeth.

But as he points out, by that stage of human development, the face and jaws have mostly stopped growing. He goes on to say that starting treatment at this age is too late, particularly if airway-related issues are to be addressed. This is why he’s a major advocate for intervention at a young age and for early orthodontic treatment.

It’s All About The Airway

The treatment programs at my practice are based on my Four Goals of Myofunctional Therapy, which are:

  • Correct tongue posture
  • Proper lip seal
  • Optimal swallowing pattern
  • Nasal breathing – day and night

These four goals also make great action items for any parent who’d like to check if their child has any of the oral myofunctional issues that could lead to health problems.

The easiest way to assess this is to look at their mouth.

We evolved to breathe through the nose. If a child is breathing through their mouth, or if their mouth is consistently open even a tiny bit during the day, or at night, then they need to be assessed by a myofunctional therapist or an airway focused dentist or doctor.

An Open Mouth Is A Red Flag

A mouth breathing habit or an open mouth resting posture means that the tongue is resting low. This matters in a growing child because when the tongue isn’t in its correct place in the mouth (at the top, filling the palate from top to bottom), then craniofacial development will likely be less than optimal.

I like this quote from the article I first quoted above by Dr. Galella:

“Human beings are obligate nasal breathers with the mouth functioning as a back-up breathing organ. The nose is the ideal organ for warming, filtration, and humidification of inhaled air. Breathing is a primal function necessary for survival and thus is a reflex function that prevails over all regulatory brain activity.

The basis of human evolutionary design is made possible because of nasal breathing. Adaptation of humans to an erect posture required an equilibrium of structure and function which allowed the back and neck to balance the head in the upright posture.1 When this equilibrium exists, predominate nasal breathing and normal tongue function, the result is normal growth as described in Part I of this series. It is when mouth breathing becomes the predominate mode of breathing that atypical growth patterns emerge.” 

early orthodontic treatment

Early Orthodontic Treatment And Your Orthodontist

I think the perspectives and concepts in this article are important to bear in mind when discussing your child’s orthodontic requirement and options with your dentist or orthodontist. I’d strongly suggest working with an orthodontist who supports early intervention, is focused on the airway and orthodontic expansion, and understands why guiding forward facial growth matters so much.

Regardless of the age of the child, the right orthodontist will be able to assess the current situation and give you good advice regarding a treatment plan that will help optimize facial growth and airway development. It really needs to be about more than straightening teeth.



  1. Pingback: My Latest Myofunctional Therapy Interview - Myofunctional Therapy Exercises for Mouth Breathing, Sleep Apnea, Braces, and Speech

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