Children

Why age seven

By around seven the first permanent molars and incisors are usually through, which is the earliest point at which the shape of the developing bite can be read: how the arches relate front to back and side to side, whether there is enough room for the teeth still to come, and whether anything is erupting off course. That is a diagnostic milestone, not a treatment trigger.

What genuinely benefits from early attention

• Posterior crossbite. A narrow upper jaw is corrected with an expander while the suture is still responsive. Correcting it later is harder and sometimes needs surgical help.
• Anterior crossbite. Lower front teeth biting outside the upper ones can wear enamel and strain the bite; it is usually straightforward to correct early.
• Severe protrusion. Upper front teeth standing well forward are considerably more likely to be injured, which is a practical argument for acting.
• Jaw relationship discrepancies. Where the lower jaw sits well back, growth is an asset, and functional appliance work is timed to it.
• Early loss of baby teeth. A space maintainer is cheap insurance against a crowded permanent tooth.
• Habits. Persistent thumb sucking or tongue thrust past the age at which teeth are affected.

Our position on early treatment

We believe in growth modification and in setting the jaw foundation correctly while it can still be influenced, because doing so reduces the likelihood of removing permanent teeth or needing jaw surgery later. That belief does not translate into treating every seven-year-old. Where a first phase would genuinely change the trajectory, we recommend it and explain precisely what it is intended to achieve. Where mild crowding sits in well-proportioned jaws, waiting is the better clinical decision and we say so.

Children in that second group go onto free recall visits — typically every six to twelve months — so eruption is watched and treatment begins at the right moment rather than a convenient one. Those visits do not cost anything.