This is the meat and potatoes of orthodontics! Usually the optimal time to treat is when the last primary molars are just starting to get loose. There are many advantages to postponing treatment until this point in time, provided that the significant early problems described in the “young children” segment are not present.
Usually kids are still cooperative and are now mature enough to perform tasks that facilitate the treatment. Also, the management of available space during the late transitional dentition (change from baby to permanent teeth) in crowding cases is critical at this time. And finally, the last chance to still manipulate the bones occur sometime between the ages of 9-11 (see Young Children).
The peak time for all this varies from child to child. When following a patient’s development, we often prefer to initiate treatment at the peak age when possible, since tooth and bone issues can be efficiently resolved at one time, thus eliminating prolonged treatment. Everybody is happy in this instance. This optimal timing of treatment for each child is best achieved when a skilled clinician has been observing this child’s development before key milestones have been reached. Therefore again, seven years old is the recommended age of first contact with an orthodontist.