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7 year old- conservative or pro-active?



Our son is 7 years old, his front perm teeth (top and bottom) are coming in very crowded. He has a crossbite. Our dentist suggested starting to remove some baby teeth and straightening teeth as we go--so we decided to consult some orthodontists. One orthodontist said to wait until 2 more top teeth come in and have a top expander put on and put braces on the top teeth. He said his approach is conservative and likes to wait until kids are older. He also said, some perm teeth may need taken out when he is older.

The second orthodontist said that he has a crossbite and an underbite and his midline is off quite a bit to the left. She suggested taking out baby teeth putting in top and bottom expanders and putting braces on the top and bottom teeth. (His bottom teeth are the most crowded)She said with this he will have straight teeth in 12 months and, there is a good chance that no teeth will need pulled. We are confused by the to conflicting approaches.

Will the expanders change his facial appearance? Can you actually intervene too early--and need longer treatment as a result? I am thinking about taking him to yet another orthodontist for another opinion--which hopefully will concur with one of the two above. Thanks.


It is not possible to diagnose without seeing the patient or models of the teeth. Both orthodontists have suggested an expander and I would favor that. As for the need to extract primary (baby) teeth, that would depend on the amount of root resorbtion of the baby teeth.

I hope this helps. Stay with a trained orthodontist. The first stage of treatment should take about six to nine months.

For more information:

Go to the Braces health topic, where you can:

Response by:

Walter C Buchsieb, DDS, MS Walter C Buchsieb, DDS, MS
Professor Emeritus - Clinical, Associate of Dentistry
College of Dentistry
The Ohio State University