With so much information—and misinformation—online, it’s no surprise that parents are often confused about the best time to start orthodontic treatment for their children. While some practitioners advocate for orthodontic intervention as early as age 3 or 4, it’s essential to approach such claims with caution and rely on evidence-based guidance.
Some clinicians and commercial brands promote early treatment using myofunctional appliances that claim to alter jaw growth, improve facial development, and even correct breathing patterns. These treatments often include exercises or devices that are said to “train” the tongue or expand the upper jaw in very young children.
However, it’s important to recognize that there is currently no high-quality, independent scientific evidence supporting these claims. Most changes shown in “before and after” photos are simply the result of natural growth, not the effectiveness of appliances or exercises.
Additionally, expecting a 3-, 4-, or 5-year-old to consistently wear a bulky appliance and perform daily exercises is unrealistic. Compliance at that age is extremely low, and such early experiences may even create negative associations with future orthodontic care—potentially causing resistance when treatment is truly needed.
Facial and jaw development is primarily determined by two key factors:
While environmental factors can play a role, no treatment—especially in very young children—can override the genetic programming that determines the size and shape of the jaws. Just as we cannot make a child taller through exercise alone, we cannot significantly change jaw growth without orthodontic or surgical intervention in later years if needed.
A frequent question I receive is about early upper jaw expansion as a way to address mouth breathing in children. While the theory may seem logical to some, current scientific literature does not support the claim that expanding the upper jaw leads to a change in breathing patterns.
Mouth breathing in children is often normal due to enlarged adenoids and tonsils—parts of the immune system that commonly swell in childhood and naturally recede with age. In most cases, nasal breathing becomes dominant between ages 8 and 10.
If a child continues to mouth breathe past this age, the first step should not be orthodontics—it should be a referral to a paediatric ENT specialist to assess for physical obstructions such as:
If obstructions are found, surgical intervention may be necessary before considering any dental or orthodontic treatment. Expanding the palate without addressing these underlying causes will do nothing to improve breathing quality.
I recommend the first orthodontic assessment around age 7 to 8. At this point, we can:
Despite this early evaluation, I very rarely begin treatment at that age. In most cases, it’s best to wait until around age 10, when natural growth has progressed further and compliance with treatment is much more realistic. Expansion, if needed at that stage, is still highly effective.
When it comes to the best time to start orthodontic treatment:
Orthodontics is not about rushing into treatment—it’s about timing it right, with a tailored approach for each individual child.
Back to Blog
I recommend and prescribe orthodontic treatments to my patients as if they were my own family and I value meaningful relationships based on communication, confidence and trust.
“I'm very happy with my treatment and results. I was delighted with Dr. Erfan Salloum's attention to detail, and so happy he took the time...”
“Over the moon with the results from my orthodontic treatment at Dublin Orthodontics. I can not speak more highly of Dr. Erfan Salloum and his...”
