Although I usually recommend a child’s first visit to an orthodontist by 7-8 years old, it is often for an initial consultation to rule out any potential growth and development problems with respect to their jaws and teeth. Ideally, there should be enough room for all future permanent dentition once the baby teeth begin to fall out. However, when insufficient space exists, it is important to intervene early to prevent severe dental crowding, blocked out teeth, and complex orthodontic treatments in the future.
In this particular case, notice how this 9 year old’s initial Panoramic x-ray shows large permanent upper canines developing on top of the roots of severely rotated lateral incisors (yellow circles). If left untreated, the permanent canines can continue to erupt in the wrong direction. This can result in unerupted blocked out permanent canines, which may also increase the risk of root damage to the overlapping lateral incisors. You can actually see an example of blocked out canines in the picture on the bottom left.
Notice how in the progress photos, after several months of early interceptive orthodontic treatment, additional space and proper path of eruption have been created for the canines, all while the front four upper incisors were aligned with full rotation corrections. Phase 1 success!!!!