Do All of My Baby Teeth Have to Fall Out Before I Get Braces?

There is no harm in seeing an orthodontist too early but there is a lot of harm in seeing one too late.

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Hi, I’m Dr. B, practicing functional dentist for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California. I'm on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. Learn more about Dr. B

Q: Hi, I am getting braces soon, and I was wondering, do ALL your teeth have to have fallen out for you to get them?

A: Great question, Brooke. Please don’t wait until all your baby teeth fall out because chances are you will have missed out on the best time for fixing your bite.

These days, the better approach involves two phases of straightening the teeth. I typically refer my younger patients to my orthodontist by age 8. There is no harm in seeing an orthodontist too early but there is a lot of harm in seeing one too late.

By age 8, it may be too early for actually having treatment but it’s not too early to determine the correct treatment plan over these transitional years of the your changing teeth. This “changing” is the time when the adult teeth are coming in and the baby teeth are falling out at the same time.

What your orthodontist will be considering is the growth of your jawbones. For example, is the lower jaw bone keeping up with the upper jaw bone in terms of growth? Often times, one jaw bone will grow faster than the other and early detection and treatment of this situation will lead to a better result than if treated later when all the adult teeth have grown in.

When both jawbones are correctly aligned, there is less movement of the teeth needed, which means a shorter treatment time and lower chance of relapse. That is why you have two phases of straightening the teeth.

Worst case scenario is that the orthodontist will see you, see that the jawbones are growing in harmony, and he or she will put you on a schedule and call you back at the appropriate time. This will give you peace of mind that you won’t miss that optimal window for fixing your bite.

By making sure that the upper and lower jaw bone grow in a balanced way, the second phase of braces a simpler and shorter process with less chance of relapse in the future. Relapse is when the teeth go back to their original crowded position as you grow into an adult. Not a good thing, Brooke, since most parents have their grown up children pay the second time around!

In other words, phase one of braces allows for the correct amount of space in the mouth for the incoming adult teeth so that when they do come in, they have room to be in the proper position. This makes phase 2 a simpler and shorter process since the upper and lower jawbones are correctly aligned.

The way I explain this to my patients is like this: Picture building a rocket and flying to the moon. Mapping out your flight plan in the very beginning will determine whether or not you have a moon to land on. Good phase 1 treatment will determine a successful moon-landing at phase 2 because you will have timed everything properly. Once you launch that rocket, there’s no changing the flight plan until you’ve completed your trip. Determine your flight plan by age 8 or 9 to guarantee a successful moon landing by age 12 or 13.

Do not wait until all your baby teeth have fallen out because you may have missed your launch window.

Mark Burhenne DDS

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