Kids get braces to correct misaligned teeth and jaws, a condition dentists call malocclusion. About 1 in 3 children has enough misalignment to benefit from orthodontic treatment, and the reasons range from crowded teeth and bite problems to jaw growth issues that affect chewing, speaking, and long-term dental health.
The Most Common Bite Problems
Teeth and jaws can be misaligned in several distinct ways, and most kids who get braces have one or more of these issues:
- Crowding: The teeth are too large for the jaw, or the jaw is too small, so teeth overlap and twist as they compete for space.
- Overbite: The upper front teeth overlap the lower front teeth too deeply in a vertical direction, sometimes covering them almost entirely.
- Underbite: The lower front teeth sit in front of the upper teeth, often due to the lower jaw growing faster or further than the upper jaw.
- Crossbite: Some upper teeth close inside the lower teeth rather than outside them, which can cause the jaw to shift to one side.
- Gaps: Spaces between teeth, sometimes from missing teeth or a mismatch between jaw size and tooth size.
These problems aren’t just cosmetic. Each one changes the way force distributes across the teeth when a child bites and chews, which can wear down enamel unevenly and strain the jaw joint over time.
What Causes Misalignment in the First Place
Genetics is the biggest factor. If one or both parents needed braces, their children are more likely to inherit a small jaw, large teeth, or a mismatch between upper and lower jaw growth. But habits during early childhood play a real role too. Prolonged thumb sucking, extended pacifier use past infancy, and tongue thrusting (pushing the tongue against the front teeth when swallowing) all create steady pressure that can push teeth out of position and alter how the jaw develops. These behaviors don’t cause problems overnight, but months or years of repetitive force add up.
Losing baby teeth too early, whether from decay or injury, is another common trigger. Baby teeth hold space for the permanent teeth growing underneath. When a baby tooth falls out or is pulled before the permanent tooth is ready to come in, neighboring teeth drift into the gap. The permanent tooth then has nowhere to go and erupts crooked or gets trapped in the bone entirely.
Why It’s Not Just About Straight Teeth
Parents sometimes think of braces as a cosmetic choice, but the health reasons are significant. Crooked or crowded teeth create tight spaces and overlapping areas where plaque and food particles get trapped. Even with diligent brushing and flossing, these hard-to-reach spots become breeding grounds for bacteria. Plaque that isn’t removed hardens into tartar, which irritates the gums and sets the stage for gingivitis and, eventually, more serious gum disease. Straightening teeth makes routine cleaning far more effective.
Misaligned teeth and jaws can also affect speech. Children with an overbite may struggle to pronounce sounds like /s/ and /z/, producing a lisp. Kids with a crossbite can have broader articulation problems, with certain words coming out muffled or slurred. An improper bite changes the airflow through the mouth and nasal passages, distorting speech patterns in ways that speech therapy alone can’t fully resolve if the underlying structural problem remains.
There’s a functional chewing component as well. When teeth don’t meet properly, kids may unconsciously favor one side of the mouth, which puts uneven stress on the jaw muscles and the joint that connects the jaw to the skull.
When Kids Should Be Evaluated
The American Association of Orthodontists recommends that every child see an orthodontist by age 7. That surprises many parents, since most kids don’t get braces until they’re 10 to 14. But at age 7, children have a mix of baby teeth and permanent teeth, and an orthodontist can spot developing problems in jaw growth, spacing, and bite alignment while there’s still time to intervene simply.
An evaluation at 7 doesn’t mean treatment at 7. Most children evaluated at this age are told to wait and come back for monitoring. But for a small percentage, early intervention (sometimes called Phase 1 treatment) can make a real difference. A short course of treatment at this stage can guide jaw growth, create space so permanent teeth erupt in better positions, and correct crossbites before they cause the jaw to grow asymmetrically. Children with craniofacial differences, including cleft lip and palate, especially benefit from early orthodontic work to address disruptions in tooth and jaw development.
How Braces Actually Move Teeth
It seems counterintuitive that teeth can move through solid bone, but the process is surprisingly elegant. When braces apply gentle, steady pressure to a tooth, cells on the compressed side of the tooth’s socket break down tiny amounts of bone, while cells on the opposite side build new bone to fill the gap left behind. This cycle of breakdown and rebuilding happens continuously throughout treatment, allowing teeth to shift a fraction of a millimeter at a time. It’s why braces need regular adjustments: each tightening resets the pressure so the cycle continues in the right direction.
This process works best in children and adolescents because their bones are still growing and remodel more quickly than adult bone. It’s one of the main reasons orthodontists prefer to treat most alignment issues during adolescence rather than waiting until adulthood, when the same corrections take longer and can be more uncomfortable.
Metal Braces vs. Clear Aligners
Traditional metal braces remain the most common option for kids. Brackets are bonded to each tooth and connected by a wire that the orthodontist adjusts over time. They work on every type of misalignment, from mild crowding to severe bite problems, and they don’t require the child to remember to put them in. That last point matters more than parents might expect.
Clear aligners are an increasingly popular alternative. Children as young as 6 or 7 can be candidates for aligners in certain early-intervention scenarios, and many children aged 10 and older are eligible once most of their permanent teeth are in. For mild to moderate cases, aligners can achieve results on a similar timeline to traditional braces. The catch is compliance: aligners need to be worn 20 to 22 hours a day, and missed wear time delays results. For younger children or kids who might not reliably keep track of a removable appliance, fixed metal braces are often the more practical choice.
The decision between the two comes down to the complexity of the dental issue, the child’s age, and honestly, their maturity and responsibility level.
How Long Treatment Takes
Treatment length varies quite a bit depending on what needs to be corrected. Minor issues like simple crowding or small gaps typically require 12 to 18 months. More complex problems, such as deep bites, open bites, or teeth that need significant rotation, can take 24 to 30 months or longer.
Five factors influence the timeline most: the severity of the misalignment, the child’s age when treatment starts, how well the child follows care instructions (wearing rubber bands, avoiding foods that damage brackets), oral hygiene during treatment, and the type of braces used. Poor oral hygiene can actually slow tooth movement because inflamed gums and bone don’t remodel as efficiently. Kids who break brackets frequently by eating hard or sticky foods also add time, since each repair appointment is a minor setback.
After the braces come off, nearly every child will wear a retainer. Teeth have a strong tendency to drift back toward their original positions, especially in the first year after treatment. Retainers hold everything in place while the bone around the teeth fully stabilizes in its new configuration.