Your child’s first orthodontic visit: what to expect

Childhood is full of milestones, from losing that first baby tooth to the experience of adult teeth coming in. And it’s vital to ensure the teeth growing in do so in a healthy, orderly manner. Whether you or your dentist has noticed a potential problem or you simply want to take a proactive step, you may decide to consult an orthodontist.

This article will help prepare you for the basics of what to expect at your child’s first orthodontist appointment, when to schedule it and how to get ready for it.

When should a child first go to the orthodontist?

It’s never too late to begin orthodontic treatment, even as an adult. However, the American Association of Orthodontists recommends that a child’s first orthodontist visit occur by 7 years old. An early checkup will let the orthodontist spot any developing problems early on. Early detection allows early treatment, which can be faster and more straightforward than addressing the issue later. The examination may even allow orthodontists to pursue treatments that will prevent further problems.

A child’s parent or dentist might notice signs to encourage an orthodontic evaluation, such as:

  • Underbites: In an underbite, the lower jaw sits positioned in front of the upper jaw when the back teeth are closed.
  • Overbites: In an overbite, the upper jaw overlaps the lower jaw when the back teeth are closed.
  • Open bites: In an open bite, upper and lower teeth don’t make contact. Open bites can be either anterior — where the front teeth don’t touch when the back teeth are closed — or posterior — where the back teeth don’t touch when the front teeth are closed.
  • Spacing issues: Teeth may be positioned either too far apart or too close together.

Some issues can be spotted with the naked eye, while others need a closer look. Even if a child’s teeth look perfectly straight, an orthodontist can spot potential problems even while baby teeth are still in place.

An evaluation may show that everything is developing as it should. If there is a developing problem, early orthodontic treatment can help guide jaw growth, adjust teeth into a healthier position and lower the risk of damage to protruding teeth.

Talking to your child about braces

It’s normal to be nervous or unsure when you’re facing a new situation. If your child is feeling uncertain or reluctant about getting braces, the best thing you can do is help them talk through their fears. Some of the most common concerns that kids have are:

  • Pain: “Is it going to hurt?” This is both the most common and biggest fear when it comes to braces. Luckily, today’s technology and techniques use gentle pressure, making braces far more comfortable than they used to be. While there will still be some discomfort, it should only be minor and temporary. Encourage your child to tell you if they’re in pain, and assure them that you’ll be there to help.
  • Embarrassment: Being different can be especially hard for children. With orthodontics growing more popular all the time, though, your child likely knows at least one person from school or activities who also has braces. If you or someone in your family wore them, pull out old pictures for solidarity. Depending on your child’s preference, encourage them to embrace standing out with colorful bands or consider clear braces to help them blend in.
  • New diet: There’s no way around it — your child may have to give up some favorite snacks or sweets. Try to focus on what they can still eat — smoothies made with seedless fruits are always a winner after adjustment appointments. Encourage them to participate in the household grocery shopping so they can pick out things they’ll like.
  • Uncertainty: Your child will likely ask how long they need braces for. While every case is different, your orthodontist will give you an estimated time frame before putting the braces on. Be open with your child about how long it will take. Together, set up periodic milestone celebrations to mark their progress.

What does an orthodontist do during a child’s first visit?

Your child’s first orthodontist appointment will be for evaluation and consultation. Here’s what to expect at the first orthodontist appointment:

Medical and dental history review

When you arrive at the orthodontist’s office for the first time, they will have new-patient paperwork for you to fill out. Along with any intake insurance information, you’ll also need to provide your child’s medical and dental history. The medical history will help them confirm that your child is healthy enough to treat. The dental history will provide information about any routine dental work or dental surgery your child has completed.
The orthodontist will include this information in your child’s diagnostic records, along with the information they gather during their exam. That information can include any pictures and models of the teeth, notes from the visual examination and X-rays.Once the diagnostic records are complete, the orthodontist will be able to diagnose any current problems or potential issues and develop a treatment plan.

Once the diagnostic records are complete, the orthodontist will be able to diagnose any current problems or potential issues and develop a treatment plan.

Orthodontic exam

The orthodontic exam will likely take up the bulk of this first visit.
The first portion will consist of a visual examination very similar to a standard dental exam. The orthodontist will examine your child’s mouth and jaws to evaluate spacing, position and jaw alignment. Someone, either the orthodontist or another staff member, may take photographs of your child’s face and teeth for their records.

Your child’s first exam should answer the following questions:

  • Are there any orthodontic problems? There may be problems the orthodontist can identify based on the visual examination alone. They will likely wait until the exam is fully complete before giving their assessment.
  • Will any teeth need to be removed? Most orthodontists prefer to avoid extraction unless it’s necessary. Extraction may be the best option in cases where a patient has too many teeth or too much crowding.
  • What options do you have to correct the problem? Depending on the issue, orthodontists may be able to offer a variety of solutions for a patient to choose from.
  • What is the recommended treatment, and how long is it expected to take? The orthodontist may recommend a particular treatment option over others. They can also give you an estimate for how long they expect the treatment to take.


X-rays are another vital part of the orthodontic exam. Though the orthodontist will perform a thorough visual examination, some problems are hidden from the naked eye. Approximately two-thirds of a tooth’s mass is hidden beneath the gums. To get an accurate idea of what’s happening below the surface, the orthodontist will take a set of X-rays.

The X-rays an orthodontist’s office uses are different from those your child may be used to from their dental checkups. Dentists typically use bitewing X-rays, which help identify tooth decay and gum disease. Since bitewings only focus on one section of the mouth at a time, orthodontists prefer to use panoramic and cephalometric X-rays.

Panoramic X-rays show the entire mouth in one picture. They help see which teeth have fully emerged, how many are still emerging and if any are impacted. Cephalometric X-rays show one side of the head, including the skull and upper portion of the spine. Orthodontists use these X-rays to examine the teeth in relation to the jaw and to help develop treatment plans.


If they believe that treatment is necessary, the orthodontist will also take impressions of your child’s bite. The impressions serve two functions. They are another piece of information for the diagnostic record. Together with the photographs and X-rays, impressions will help the orthodontist develop a treatment plan.
The impressions also act as a model for the orthodontist to make appliances — braces, aligners or retainers — custom-suited to your child’s mouth.
Orthodontists used to take Impressions physically. The patient would bite down on a putty-filled tray to form the impression mold. Now, most impressions are digital. The process for digital impressions is much faster, and the impression can be completed in just minutes. Digital impressions are also more accurate. There is less need for adjustments or “tweaks” during treatment with the digital method.

Exploring treatment options

Finally, once the orthodontist has completed the exam, they will discuss any concerns they found and what treatment options are available.

Braces are the most common orthodontic treatment. Brackets are fixed to the teeth and strung through with wires, which are periodically tightened to guide the patient’s teeth into alignment. Tiny rubber bands called “ligatures” or “o-rings” wrap around the brackets to hold the wires in place. Depending on the orthodontic problem, lingual braces — attached to the back of the teeth instead of the front — might be an option.If the orthodontist believes that additional encouragement is necessary for alignment, they may recommend using power chains instead of o-rings. Instead of individual bands for each bracket, power chains stretch across multiple teeth.

If the orthodontist believes that additional encouragement is necessary for alignment, they may recommend using power chains instead of o-rings. Instead of individual bands for each bracket, power chains stretch across multiple teeth.
If the orthodontist believes that additional encouragement is necessary for alignment, they may recommend using power chains instead of o-rings. Instead of individual bands for each bracket, power chains stretch across multiple teeth.
Clear aligners could also be an option for your child. Rather than attaching to the patient’s teeth like metal braces, clear aligners are sets of clear plastic trays that gradually guide the teeth into alignment. The orthodontist designs the sets based on the patient’s impressions. The patient wears each set for one to three weeks.

Questions to ask the orthodontist

Starting a brand-new orthodontic process can be daunting. It’s a whole new world that you’re just beginning to explore. You’ll find it’s easy to navigate if you come prepared with any questions you might have. Here are a few orthodontic consultation questions to get you started:

What’s your background and experience?

You probably looked into this when you were choosing an orthodontist, so you already know the answer. Still, hearing how someone describes their history can give you insight into their character and personality. Find out what organizations and associations they belong to. Do they have years of experience in orthodontics, or are they just starting?

How long will the treatment take?

Treatment time will vary from patient to patient based on the complexity of the case. Find out what your expected timeframe will be. Will there be any significant milestones to watch for? What are they, and when should they happen? Orthodontics is a careful process, and having an end date in mind can help you and your child feel like it’s a little more manageable.

How often will we need to come into the office?

Whether it’s for adjustments or just so the orthodontist can check on progress, your child will need to visit the office periodically. The orthodontist will let you know how frequently based on your treatment plan.

Can we see examples of your work?

This is a great way to understand what types of issues an orthodontist sees most often. They should be happy to show you before and after photos from their former clients. This can also be an excellent opportunity for your child to see people their age who went through the same process. Seeing the happy smiles in the “after” pictures can help soothe any remaining nervousness.

What do I do for my child at home?

The orthodontist will be able to walk you through the basics of what your child will need to keep up with oral hygiene during this process. They can also offer advice for some of the trickier areas, like flossing around braces. You will get general dietary suggestions, but many offices also provide lists of food to avoid. They may have other suggestions for ways to make this sometimes uncomfortable experience better for your child.

Can you be in the orthodontist’s exam room with your child?

The short answer is yes.
An orthodontist’s office is a new place where your child will be going through a brand-new experience. You both might feel a little overwhelmed. And if you have questions, your child probably isn’t sure what to expect at their first orthodontist appointment either. If it would make one or both of you feel better to have you in the exam room, that is where you should be.

The first visit is about answering the initial basic questions to determine the necessary treatment. It’s also about building trust. Having you there can help your child start to trust the orthodontist. Being able to ask your questions as they come up will help you begin to do the same. And seeing you take an active interest will assure the orthodontist that you will make sure your child takes their orthodontics as seriously as you do.

What if your child has special needs?

If your child has special needs, a few extra steps when preparing for their visit will make it a more relaxed and pleasant experience.

When you make your appointment, be sure to inform the orthodontist’s office of any needs your child may have. If there are aspects of their regular dental visits that your child finds difficult, such as strong smells or other sensory issues, ask the office if they can adjust to accommodate them. If your child does better in a quiet environment, ask to schedule the exam for a time when there are fewer other appointments. The office will let you know if there are any accommodations they can’t provide.

You can also help your child prepare for the visit by giving them an idea of what to expect. Show them pictures and videos of the procedures. If you already suspect braces will be necessary, talk to them about the equipment and appliances. Ensuring they know what to expect going in will help their stress.
In cases where the orthodontist does advise braces, consider clear aligners rather than metal braces. Aligner trays are removed for eating and brushing and are more comfortable and create fewer sensory issues for children with special needs.

Schedule a consultation with Fredericksburg Orthodontics

Now that you know what to expect at their first orthodontist appointment, you’re ready to get your child started on the road to a healthier smile.

Fredericksburg Orthodontics has been serving Fredericksburg and the surrounding communities for over 16 years. Dr. Almy is certified by the American Board of Orthodontists and a Diamond Plus Provider of Invisalign® treatment, and our staff is friendly and welcoming. We take the time to personalize your treatment and address all of your questions and concerns.
Visit our site today to request a complimentary consultation for your child! Check out our blog to learn more.