The American Association of Orthodontists® recommend that your child comes in for their orthodontic screening at 7 years old. By this age, most children have a mix of baby teeth and adult teeth, making it easier for our orthodontist to diagnose and identify any potential issues that might need to be addressed sooner rather than later depending on growth, development and eruption of permanent teeth.

Why we recommend a consultation/evaluation at age 7 for your child:

  • Ensure and help your child’s secondary (adult) teeth come in when and where they should
  • Provide more space for crowded teeth
  • Manage crowding
  • Monitor, guide or correct your child’s jaw development
  • Regulate the width of both arches of teeth
  • Eliminate any crossbite in the front or the back that could contribute to bite issues, jaw issues, gum issues or possible trauma
  • Correct a thumb sucking habit
  • Address any social or esthetic concerns your child might have

Signs that your child may need orthodontic treatment:

  • Early or late loss of baby teeth
  • Crowded front teeth around 7 or 8 years old
  • Crowded, misplaced or blocked out teeth
  • Teeth that are gapped or abnormally crowded
  • Finger or thumb sucking habits

Does every child need early treatment?

Nope! While some children need early treatment for the issues described above, more often than not, we just need to monitor growth and eruption with orthodontic “checkups”, called growth observation appointments, every 6-12 months starting at age 7. These growth observation visits are all completely free but are extremely important. Dr. Katie Doswell updates your child’s photos, takes a look at their teeth and captures one or two X-rays (if needed) to evaluate your child’s teeth and growth. These visits help us get to know your child’s teeth and how they are growing, so we can start treatment at the ideal time, which usually ends up being around age 11 or 12.

What does early treatment for children look like?

If needed, most early treatment for children, known as Phase I, consists of braces on the top front four teeth, bands or braces on the top 6-year molars and sometimes braces on a few bottom teeth. If your child has a crossbite in the back, an expander is usually needed to widen the upper jaw and eliminate the crossbite. Treatment of crossbite correction is most beneficial and effective starting at age 8 because of growth patterns (how and when your upper and lower jaws grow) and tooth eruption patterns. If we see your child at age 7 for an initial consultation, we can catch any of these problems early to address them and make future treatment easier and usually faster.


Most adolescents no longer have any baby teeth around age 11 or 12, and their 12-year molars are on their way in and are growing — all variables we evaluate to determine a patient’s readiness for orthodontic treatment. Growth, development and timing are different for each individual though. When you come in for your initial consultation, we will evaluate if your teenager is ready for treatment; and if not, when they will be ready based on their growth, development and tooth eruption.

What are the options for my teenager or soon-to-be teenager? 

Both braces and Invisalign clear aligners are options for almost every patient. The only caveat is that Invisalign only works if you wear it. Some patients (children, teens and adults) admit that remembering to wear their aligners 20-22 hours per day and switch them out weekly can be challenging. We will give you tips on how to remember, but for some, braces might be a better option for your lifestyle and activities. We will talk to you about the pros and cons and what might be best for your teen.


There has been a very noticeable trend involving more and more adults seeking out orthodontic treatment: the number has increased significantly in more recent years, and thankfully, there are options to fit every lifestyle.

Most adults ask if Invisalign treatment is an option. The answer is almost always yes.

At Doswell Orthodontics, we are able to show you a simulation of what your smile will look like at each stage of the straightening process, and do so before you get started with treatment. The main reasons why adults prefer Invisalign aligners is because it is an aesthetic option: it allows you to take treatment at your own pace (we will help figure out the best schedule for you), have fewer emergency visits, travel for long periods of time while still being monitored closely or even live elsewhere for a portion of the year. Whatever your life looks like, we can almost always make Invisalign treatment work for you and your treatment goals.

Braces are also a great option for adults. Some adult patients prefer not having to remember to change their Invisalign trays on a weekly basis, and some want the fun colors that they may have missed out on as a teenager.

Why should you consider orthodontic treatment?

  • Straighter alignment improves your health – Tooth decay can happen much easier when plaque gets caught in the spaces between crooked teeth. Straighter teeth help make brushing and flossing easier, and improve your oral health.
  • Be confident in your smile – You should never be self-conscious about your teeth or smile. If straighter teeth and a more confident smile is something you want for yourself, we have treatment options available for you and flexible financing to make it possible to give you the confidence you want and need in your smile.
  • Crowding usually gets worse as you get older — Unfortunately not many things get better as we get older, and crowding is one of those things, especially in the lower front area. If you have experienced this crowding or any shifting of your teeth and bite as an adult, we can help correct it and help you maintain your newly straightened teeth with retainers for the rest of your life.

We help patients of all ages achieve a healthy, beautiful smile. Give us a call at 804-256-2808 to set up your free consultation and to learn more about your orthodontic options in Richmond, Virginia.