Orthodontic Treatment For Children In 2026: What Every Parent Should Know

Orthodontic treatment for children doesn't have to start at 7. The American Association of Orthodontists (AAO) puts it this way: "For many children, a single phase of comprehensive orthodontic treatment is still the right path." That single phase usually starts once most or all adult teeth are in. Going by the American Dental Association's eruption chart, that's around ages 11 to 13.

A short list of problems is worth acting on earlier, while a child still has a mix of baby and adult teeth. Those are a back-tooth crossbite that shifts the jaw, a front tooth stuck behind the lowers, front teeth 5 mm or more ahead of the lowers, an adult canine coming in the wrong way, and a thumb habit that's opening the bite. We monitor the rest at regular checkups every 6 months.

Orthodontics is mostly a kids' treatment. In 2019 federal survey data, 67.6% of people who reported orthodontic care were under 18, according to a 2023 analysis in Dentistry Journal. In 2022, AAO members were treating about 3.15 million U.S. kids ages 8 to 17, roughly 7.4% of that age group.

What is orthodontic treatment for children?

Orthodontic treatment for children is planned correction of crooked teeth, bite problems, and jaw growth. It uses appliances such as expanders, space maintainers, partial or full braces, clear aligners, and retainers. The American Association of Orthodontists recommends a first check-up with an orthodontist by age 7. A check at 7 doesn't mean braces at 7.

In the AAO's own words, "Not all early visits result in orthodontic treatment." Kids who don't need treatment yet get followed while the face and jaws keep growing.

Which problems need treatment now, and which can wait?

The evidence supports acting early when a problem shapes the jaw or puts front teeth at risk of injury. For an overbite (Class II bite) without that risk, 1 round of treatment later works as well as 2.

The table sorts 8 common problems by when the American Academy of Pediatric Dentistry (AAPD) supports acting, based on its guidance on bite development, revised in 2024.

Problem	When to act	Evidence (AAPD, 2024)
Back teeth in crossbite, and the jaw slides to one side to close	Correct early	Jaw shifts "should be eliminated as soon as possible"
1 or more upper front teeth tipped behind the lowers (not a jaw-size problem), with room to move	Align as soon as it's noticed	A simple front crossbite "can be aligned as soon as the condition is noted"
Upper front teeth sit 5 mm or more ahead of the lowers (overjet)	Consider early treatment to lower injury risk	Overjet over 3 mm is linked to more front-tooth injuries. Over 8 mm, more than 40% of children injure a front tooth. Treating at 5 mm or more may lower the risk.
Thumb or pacifier habit after age 3, with an open bite or crossbite	Help the child stop. Orthodontics can correct the bite changes.	The AAPD suggests helping kids stop by 36 months and links long-term habits to open bite and crossbite
Adult canine coming in the wrong way	Consider removing the baby canine	Removing the baby canine fixed the path in 67% to 69% of cases, compared with 39% to 42% when it stayed
Baby molar lost early	Consider a space maintainer	The AAPD says to consider one, and notes that evidence on how well they work is lacking
Crowded lower front teeth	Hold the space with a lower lingual arch, sometimes after removing the baby canines	With that approach, about 6 in 10 kids had room for every adult tooth with no added expansion, and about 9 in 10 with 2 mm of expansion
Overbite (Class II bite) with overjet under 5 mm	1 round of treatment later is an option	1 phase or 2 phases can correct a Class II bite, and 2 phases take longer in total

We see children from age 1, or 6 months after the first tooth comes in, whichever is earlier, and we monitor growth and development at every 6-month checkup. That's about 12 checkups before age 7.

In row 5, the fix is removing a baby tooth that's in the adult canine's path. No appliance is involved.

Does early orthodontic treatment save time or money?

For Class II bites, the randomized trials say no. Starting at 8 to 10 adds visits, months, and cost, and the result is no better than 1 round started around age 12.

The clearest test is a UK trial of 174 children ages 8 to 10 with Class II bites, where the upper front teeth stick out past the lowers. It was published in 2009 in the American Journal of Orthodontics and Dentofacial Orthopedics. Kids treated early "had more attendances, received treatment for longer times, and incurred more costs" than kids treated once in adolescence, at an average age of 12.4. Their jaw relationship, extraction rate, and self-esteem came out the same. And the early group's final bite scored worse, or in the authors' words, "significantly poorer final dental occlusion."

The AAPD's 2024 guidance lands in the same place. Either 1 phase or 2 can correct these bites. Treatment in 2 phases takes longer in total, even though the teen round in full braces can be shorter.

For protruding front teeth, early treatment has 1 payoff with trial support: fewer front-tooth injuries. A 2018 Cochrane review included 27 trials with 1,251 children. In the trials that tracked injuries, early treatment cut new front-tooth injuries. Cochrane rated that evidence low to moderate quality and found no other advantage over treating later.

That's the reason behind the age 7 check in the rule of 7: catching the kids in rows 1 through 5 of the table above.

The 4 stages and how long each one takes

Phase 1 fixes 1 or 2 specific problems while a child still has a mix of baby and adult teeth. Phase 2 lines up the full set of adult teeth, and a retainer holds the result from then on.

Stage	Typical ages	What it does	How long
Phase 1, only if needed	6 to 10	Fixes 1 or 2 problems from the table above	9 to 18 months at Mini Miners
Rest period	Between phases	Adult teeth come in, and we check growth and development at each 6-month visit	Depends on the child. The AAO doesn't give a set length.
Phase 2, or the only phase	Once most or all adult teeth are in, often 11 to 13	Full braces or clear aligners	12 to 24 months for most people (AAO). 19.9 months on average across 22 studies of fixed braces.
Retention	After braces or aligners come off	A retainer holds teeth in place	Full-time "for a few months," then nightly, indefinitely (AAO)

Phase 2 timing tracks tooth loss. Eruption charts from the American Dental Association show the last baby molars usually falling out between ages 10 and 12.

We do early orthodontic care in the same Erie office where your child gets cleanings. Depending on the problem, that's a removable appliance for a simple crossbite or partial braces on some teeth instead of the full set. We also offer Invisalign clear aligners made for younger kids.

Braces vs clear aligners for kids under 12

Both are options at Mini Miners: partial braces placed on some teeth instead of the full set, and Invisalign clear aligners made for younger kids. The trade-off is wear time.

Aligners come out for eating and brushing, and they only move teeth while they're in. Align Technology, the company that makes Invisalign, tells patients to wear them 20 to 22 hours a day. Its Invisalign First line is made for Phase 1 treatment in kids ages 6 to 10.

Braces stay on until they're removed at the office, so they don't depend on a child remembering to wear them.

How much does orthodontic treatment for children cost?

There's no single price. The cost depends on the appliance, how long your child wears it, and whether they need 1 phase or 2.

The AAO's cost guide for families gives no national price range. It tells families to get a personalized estimate from an orthodontist instead.

Insurance changes what you pay. FAIR Health is a national nonprofit that publishes health care cost data. It says plans that cover orthodontics often pay up to 50% of the charge, up to a lifetime dollar maximum. Some plans limit that coverage to kids under 19, and some cover only orthodontics the plan considers medically necessary. A typical PPO plan, in the American Dental Association's example, caps orthodontic benefits at a $1,000 lifetime maximum.

Mini Miners accepts all major private insurance and offers payment options for Phase 1. Billing is clear and no-nonsense. Families without dental insurance can ask about the Mini Miners Membership Plan.

Keeping appliance visits calm for anxious and sensory kids

We adapt each visit to the child. Visits stay positive and brief on purpose, so kids are willing to come back.

Every treatment room at Mini Miners Pediatric Dentistry is plumbed for nitrous oxide, so an anxious child can have laughing gas while braces go on without moving to another room. Our chairs can stop partway back, so a child who won't lie flat can have a cleaning and X-rays partly sitting up. Parents can stay with their child during treatment, and we explain and show your child what we're doing.

Existing patients with a dental emergency can call (303) 500-3202 and press 2 to reach the Mini Miners pediatric dentist on call. We always work to see patients of record the same business day.

Retainers are for life, at night

Plan on nightly retainer wear for life. The AAO's answer to how long is "Ideally, forever."

After braces or aligners come off, its guidance calls for full-time wear "for a few months," then nights. To keep teeth from shifting, it recommends wearing a retainer nightly, indefinitely.

Relapse is the reason. A 1999 study in the American Journal of Orthodontics and Dentofacial Orthopedics followed treated patients for up to 10 years after retention, starting with 1,016 people. At 10 years, 67% of the treatment result had held. About half of all the relapse happened in the first 2 years after retention.

Book an orthodontic evaluation in Erie

Bite checks are part of every regular visit. At each 6-month checkup, our team monitors your child's growth and development.

The right time to start orthodontic treatment for children depends on the problem. If your child is 7 or older and hasn't had a bite check, or you've spotted anything from the table above, book an orthodontic evaluation. If we notice a problem that would benefit from early treatment, we'll discuss the options with you.

Frequently Asked Questions

How much does orthodontic treatment for children cost?

The price depends on the appliance and on whether your child needs 1 phase or 2. When a dental plan includes orthodontics, it often pays up to 50% of the charge up to a lifetime maximum, according to FAIR Health. The American Dental Association's example of a typical PPO plan caps that orthodontic benefit at $1,000. Mini Miners accepts all major private insurance and offers payment options for Phase 1.

Is Phase 1 orthodontic treatment always necessary?

No. The American Academy of Pediatric Dentistry says early treatment "is beneficial for many children but may not be indicated for every patient." For Class II bites, a 2009 UK trial found that starting at 8 to 10 added visits, time, and cost, with no better result than 1 round of treatment started at about age 12.

How long does orthodontic treatment for children take?

Phase 1 at Mini Miners usually takes 9 to 18 months. Most people wear braces for 12 to 24 months, per the American Association of Orthodontists, and a review of 22 studies put the average at 19.9 months. A nightly retainer follows, indefinitely.

Can kids under 12 use clear aligners?

Yes. Align Technology makes Invisalign First for Phase 1 treatment in children ages 6 to 10. Aligners need to be worn 20 to 22 hours a day and only work while they're in. Braces stay on, so they don't depend on a child remembering to wear them.

What happens if my child stops wearing a retainer?

Teeth start drifting back toward where they started. In a study that followed treated patients for up to 10 years after retention, about half of all relapse happened in the first 2 years. The American Association of Orthodontists recommends wearing a retainer at night indefinitely.

Does early treatment prevent tooth extractions later?

In the best trial evidence for Class II bites, it didn't. A 2009 UK trial of 174 children found no difference in extraction rates between kids treated at 8 to 10 and kids treated at about 12. Removing a baby tooth early can still help an adult canine that's coming in the wrong way. Guidance from the American Academy of Pediatric Dentistry reports it fixed the canine's path in 67% to 69% of cases, compared with 39% to 42% when the baby tooth stayed.