The American Association of Orthodontists recommends children be seen by an orthodontist at age seven. This is an ideal time to start each child who presents with an orthodontic problem. It is not necessarily based on their age, but rather based on their growth and stage of development. Dr. Paulus tries to avoid extracting permanent teeth unless absolutely necessary to gain enough room to straighten the teeth.

Many children do not need to start braces until most or all of their permanent teeth come in---between 11 and 13 years old. Some children with certain malocclusions will require a first stage of orthodontics for about a year at an earlier age---7 through 9 years old---and then a second stage of orthodontics after all their permanent teeth come in. A small percentage of children with severe malocclusions require starting early treatment and leaving the braces on until all the permanent come in.