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Orthodontic Referral

mixed dentition ortho referral.jpg

Why Does My Child Need an Orthodontic Referral?

Most kids approximately 7-8 years of age will be advised to have a radiograph taken: the panoramic image. This is an image used to determine the development and angulations/eruption paths of the permanent teeth. It is a key tool in a pediatric dentist’s treatment plan consideration to determine dental age, cavity treatment options and whether your child is advanced or delayed in the exfoliation process.

The panoramic image is also a key radiographic tool for both Dr. Karen and Dr. Bianca and the orthodontist that we will collaborate with to devise a treatment plan for your child that maximizes growth and development potentials. Dr. Karen or Dr. Bianca will advise of if an examination with an orthodontic colleague is required so that a critical growth period is not missed in aiding for best overall arch and skeletal tooth orientations. 

The age group of 7-10 is one of significant changes as children have many teeth in transition. Some might be very loose baby teeth with varying eruption levels of the permanent teeth. Pronounced, serrated edges of the newly erupted, less pristinely white, permanent teeth and non-scalloped gum lines, rather rounded and bulbous, call attention to many parents in a worrisome manner. This is the typical appearance for your young child newly entering what we call the early transitional dentition stage. Some parents see a gap in the front teeth which may eventually close. 

Others note that there is a gap between their top and bottom arches where it appears that one jaw is significantly shorter than the other. A crossbite may become more evident, be it a full side or a single, front tooth. All of these visible growth and skeletal variations are likely more evident to a parent at this stage. This is normal and is why this is the age of orthodontic evaluation to address such variances like these.


Even if your child has seemingly straight teeth, they may still require a referal due to issues such as clicking, grinding, popping, asymmetry concerning the preserved function of your child’s TMJ, or snoring/breathing. All of these are in relation to the broad, openness of the integrated arches and the positioning of the tongue. Perhaps your child is struggling with stopping a habit of thumb sucking or tongue thrust. Aside from varying alternatives to aiding in the cessation of a habit, there also exist appliances that are hugely functional in more immediate cessation.

Kids Playing Tug of War

Jaw growth patterns in this age are generally the reason to be referred to an orthodontist. Examples include: compromised angulations of permanent teeth seen on the panoramic image, habits that may be potentiating a jaw discrepancy, tonsillar/adenoid and tongue posture concerns that may be affecting the arch structures and breathing/snoring.

Most children are prescribed a functional appliance or limited braces. Treatment time is shorter and an annual assessment evaluates if comprehensive braces are needed. Early orthodontic correction also aims to decrease treatment time in the future.

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