Normally the fixed braces should start at age 12-13 when all the permanent teeth fully erupt. However, parents should bring their child to see orthodontic specialist at age of 9 years at the latest.
- At the age of 9, the upper canine is travelling to the area of apex of incisors so that it should be palpable at this age. If the orthodontist cannot feel the bone prominence, it is possible the canines is erupting to the wrong area. The radiograph should be taken to locate the canine.Failing to erupt in the suitable canine spaces can cause several problems.
- The canine gets stuck and fail to erupt. Consequently, the adjacent tooth drift into the canine space increasing the difficulty of the future orthodontic treatment. The regaining the spaces with active orthodontic plate is required for facilitate the eruption
- If the canine erupts in the wrong path, it may collide with the root of the incisor causing the root resorption. Thus, the orthodontist has to intercept by pulling it to the right direction (artificial direction)
- The orthodontist will check if the relationship of top and bottom jaw is correct. If there is a disproportionate growth between the top and bottom jaw, growth modification can be done at this age as the patients is still growing. This will improve the confidence of the young patients as well as reducing chance of trauma of top front teeth in the case that top front teeth is sticking out due to the delay growth of the bottom jaw.
- The orthodontist will assess if there are adequate spaces for premolars to erupt. If the patients lose their baby tooth prematurely, the permanent molars may tip into the spaces and prevent permanent premolars, which will replace the baby molar at age of 10-12, to erupt into the correct position. The active plate to regain the spaces will be recommended.