Question: My six year old’s new front teeth are coming in twisted. Should I take her to an orthodontist?

Answer: Beginning around age five or six every child begins to get their adult set of teeth. Usually we see the “six year molars” appear behind the last baby teeth. Shortly afterward the two middle front bottom teeth will get loose and come out, allowing for the new incisors to make their way into the mouth. This is usually a great time to have an evaluation of your child’s bite. Your general dentist will check this at your regularly scheduled hygiene appointment. This is a good time to start talking about options for any treatment that may be recommended. Some general dentists and pediatric dentists have training in orthodontics in addition to their primary discipline. These dentists may do some orthodontics in their practice and feel comfortable treating your child. Most dentists will refer to an orthodontist. Orthodontists are specialists that have 2-3 more years of training beyond dental school in orthodontics and limit their practice to orthodontics only. An orthodontist not only does braces, but also monitors growth and development. An early consultation with an orthodontist may seem unnecessary to some parents since the child doesn’t have all their adult teeth, but actually monitoring is important. During a consultation to an orthodontist, she/he may gather information and records to determine whether your child might need some early form if intervention. It has become more frequent that the child may need some form of an appliance to expand the arches to allow all the teeth to come in. In years past, many people had to have teeth removed during the process of orthodontics. This is no longer the case, and many other benefits can be obtained by early intervention.

 The American Orthodontic Society recommends that a child be seen for an orthodontic consult and the first sign of an orthodontic problem, or by age 7 at the latest. As I said, this first contact is usually with your child’s dentist. The dentist will decide if a consult with an orthodontist is necessary. In my practice I actually do treat some children with appliance therapy and orthodontics. In the majority of cases I refer to an orthodontist though, and encourage patients to seek several opinions if they have questions about their child’s recommended treatment.

Dr. Deborah Petronio can be reached by calling Aurora Dental Care at 652-0190 or visiting