Concerned about your child’s teeth? While the field of orthodontics has a long way to go in providing compassionate care for people with developmental differences, your child has the right to quality dental care — the same as anyone else.

The general recommendation is that kids should see an orthodontist by age 7. This is so the orthodontist can identify and address issues before they become more serious. The orthodontist will evaluate your child’s jaw, alignment, bite, baby and permanent teeth, plus skeletal development to make sure it’s all progressing the way it should. This is important because some jaw issues can be corrected in early childhood, before the jaw stops growing. Keep in mind that orthodontists do more than just install braces. Most orthodontic issues are inherited; orthodontists can find problems before your child’s permanent teeth have all come in. Your child doesn’t have to have a referral from the dentist to see an orthodontist. Usually parents are the ones to spot the signs, anyway.

It’s important to know that there are no physiological differences in the teeth of autistic kids. This means that your child’s teeth aren’t different from any other child’s teeth just because they’re autistic. Autistic kids experience the same dental issues as any other kid, but may be more prone to certain ones than their non-autistic peers. Reasons for this may include mouth sensitivity, poor oral hygiene, and difficulty accessing quality dental care.

Here are some common reasons an autistic child may need to see an orthodontist:

Malocclusion (crowding and bite alignment issues). Overbites, underbites, “open” overbites, crooked teeth, crowded teeth, and gapped teeth are all examples of malocclusion. Autistic kids are more prone to malocclusion than their non-autistic peers. We’re not exactly sure why this happens. Autistic kids tend to have more sensitive mouths than neurotypical kids. This makes it hard to get the preventive care they need to stop malocclusions from happening. Malocclusions can make it hard to get teeth clean, leading to more cavities. Malocclusions can contribute to speech difficulties and cause problems in the way your child’s mouth functions.
Delayed or early expulsion (permanent teeth coming in late or early). Neurodivergent kids sometimes have permanent teeth that come in too early or baby teeth that fall out too late, which can cause a lot of pain. Early expulsion can lead to crowded teeth (teeth overlapping with each other). It’s not exactly clear why neurodivergent kids struggle with this, or if they have more expulsion problems than non-autistic kids. The field of orthodontics doesn’t have much research about treating autistic patients.

You can read more in our guide on orthodontics.

Unless your child needs braces for health reasons, it’s okay to opt out. (This is a decision you and your child should make together along with the input of your dentist and orthodontist.)

The process of getting and maintaining braces can be very overwhelming for autistic kids. Your child would have to sit still for many appointments while their dental hardware is installed and adjusted. The daily maintenance, pain, and adjusting to changes within the mouth can be hard, too. Many kids with autism have difficulty with oral hygiene, and traditional braces make it even harder to clean teeth. For all these reasons, autistic people may find it easier to wait until they are adults to get braces.

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