The American Association of Orthodontists recommends that all children be screened orthodontically at age seven. Sometimes the reaction to this is one of surprise (“Isn’t that young?”) or suspicion (“Orthodontists can’t wait to get your money.”). There are, however, very sound reasons for this recommendation. The intent of the age seven screening is to confirm radiographically that the development and eruption of the permanent teeth is proceeding normally, without complication. (This cannot be determined by visual examination alone and is not reflected in the appearance/relationships of the primary teeth.) For those children without complications, the orthodontist will periodically monitor development free of charge. For children with unseen issues, such as a poorly resorbing primary tooth blocking the pathway of the associated permanent tooth, early intervention can prevent what would otherwise result in a significant malocclusion. In the case noted, the well-timed extraction of the “baby” tooth would allow the permanent tooth to self-correct, moving toward its proper position. Other issues that may be discovered include congenitally missing permanent teeth, extra (supernumery) teeth, malformed teeth, and damage to the roots of erupted permanent teeth due to misdirected (ectopic) eruption of other permanent teeth. The “7-up” check-up is a service that is intended to reduce both the impact of these potential issues on the forming occlusion and the extent of orthodontic treatment, if needed, in the future.
