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Age-Appropriate Tooth Alignment Management

Published: 2024

Developed by: IAPD Science Committee

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Executive Summary

Occlusion is an integral component of the maxillofacial complex, and its development begins early in life and continues through adolescence. Proper alignment of teeth and harmonious occlusal development are important for oral function, facial aesthetics, and psychological well-being.

Untreated malocclusions may contribute to dental caries, periodontal disease, temporomandibular disorders, abnormal craniofacial growth patterns, and compromised facial aesthetics. Early orthodontic evaluation allows clinicians to identify developing skeletal or dentoalveolar discrepancies and implement interceptive interventions where appropriate.

Core principles include:

  • Early identification of malocclusions during the primary and mixed dentition
  • Use of visual treatment objectives to guide treatment planning
  • Implementation of interceptive orthodontic interventions when indicated
  • Prevention of trauma, functional impairment, and worsening skeletal discrepancies
  • Collaboration with orthodontic specialists for complex cases

Early orthodontic management can reduce the complexity and duration of comprehensive orthodontic treatment later in adolescence.

Age appropriate tooth alignment…

IAPD Consensus Recommendations

Early diagnosis and intervention of malocclusions can address developing skeletal, dentoalveolar, and muscular imbalances and reduce the need for complex orthodontic treatment in adolescence.
(Consensus-based statement; Global agreement: 98%)

Visual treatment objectives should be used to guide treatment planning and optimize occlusion and facial form during growth.
(Consensus-based statement; Global agreement: 93%)

Simple appliances and eruption guidance methods such as space maintainers, space regainers, or extraction of primary canines may be used to manage arch length discrepancies, crossbites, and minor malocclusions during the primary or early mixed dentition.
(Consensus-based statement; Global agreement: 95%)

Early management of Class II and Class III malocclusions may reduce the risk of incisal trauma and temporomandibular disorders.
(Consensus-based statement; Global agreement: 98%)

Referral to an orthodontic specialist should be considered when complex cases are identified.
(Consensus-based statement; Global agreement: 100%)

Related Educational Resources

To support clinical implementation and knowledge translation, IAPD has developed complementary educational materials.

IAPD Podcast Series

The IAPD podcast series explores evidence-based approaches to paediatric dental care and clinical decision-making.

Listen on the Colgate Oral Health Network

IAPD Webinar

Selected IAPD webinars address pain management strategies and clinical decision-making in paediatric dentistry.

Watch on the IAPD YouTube channel

Suggested Citation

International Association of Paediatric Dentistry (IAPD).
IAPD Foundational Articles and Recommendations on Behaviour Guidance in Paediatric Dental Patients.
Originally published 2019. Global Agreement Validation 2022.

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