What Happens at the First Orthodontist Appointment, Step by Step

At a first orthodontist appointment, the orthodontist examines your bite, takes X-rays and makes a digital scan of your teeth. Braces usually do not go on that day. They go on at a later appointment, once the records have been reviewed and treatment is planned.

For families in Blue Bell and Lower Merion, the practical questions start before the exam: which office to choose, how much time to allow and what your child should expect. Adults coming in for their own care can use the same preparation.

Which office should you book, and at what age?

Our Blue Bell office can be reached at (215) 367-5385, and our Lower Merion office at (610) 667-6770. Choose the location that will be easier to reach for follow-up appointments, especially on school nights.

The American Association of Orthodontists recommends a check-up no later than age 7, when the first permanent molars and front teeth have usually come in. A check at 7 does not mean braces at 7. The recommendation may be to watch how the bite develops.

If you are planning around a school break, confirm appointment availability and holiday hours before arranging time off.

Our children's orthodontic care page explains warning signs that deserve a check. Find location details for Blue Bell and Lower Merion, or use the Appointment Request form to request a visit.

What to bring and what to finish online first

You can complete our Patient Forms online before the appointment to shorten check-in. Keep your questions in writing so you do not have to remember them during the discussion.

• Bring your dental insurance card so your orthodontic benefits can be checked.
• Bring dental X-rays taken within the past year, or ask your dentist to send them ahead.
• Note what prompted the visit, such as crowding or a dentist's recommendation.
• Mention habits such as thumb sucking, and symptoms such as mouth breathing or snoring.
• Ask whether the consultation fee includes X-rays and other records.

Some offices schedule the consultation and diagnostic records separately. Confirm what your appointment includes before you book.

How long the visit takes

Plan on roughly 45 minutes to an hour, plus about 10 minutes if the paperwork was not finished online. A visit with X-rays and records can run longer, up to two hours in some cases, so ask the office how long to set aside.

A mid-morning appointment may suit a younger or anxious child better than a visit after a full school day. If you need an after-school slot, leave enough travel time to arrive without rushing.

Will the first visit hurt?

The exam does not hurt. A consultation involves no drilling and no tightening, although you should ask what is planned if treatment has also been scheduled.

A panoramic X-ray requires your child to hold still for about 20 seconds while the machine captures the teeth and developing teeth within the jaw. Explain that stillness beforehand rather than describing the visit as something to endure.

If your child is anxious or has struggled with dental visits, mention it when you book. Tell the team what has been difficult before, such as gagging or discomfort with unfamiliar equipment.

What the digital scan feels like, with no putty

We use iTero digital scanning instead of traditional putty impressions. A small handheld wand passes over your teeth while a three-dimensional model appears on a screen. There is no tray of impression material to hold in your mouth.

The scan records the shape and position of your teeth for treatment planning. Our iTero digital impression page explains how the technology replaces traditional molds.

What the exam checks across teeth, bite, jaw and habits

Straight-looking front teeth do not tell the whole story. The exam also checks whether the teeth fit together comfortably and whether there is enough room for teeth still coming in.

Why orthodontists take different X-rays from a dentist

A dentist's small bitewing images show a limited area. A panoramic X-ray gives the orthodontist a broader view, including the roots and the teeth still forming in the jaw. About two thirds of each tooth sits below the gum line, where an exam cannot reach. A side-view X-ray may also help assess the relationship between the teeth and jaws.

The four things the exam checks

The orthodontist looks beyond individual crooked teeth to assess:

1. How the upper and lower teeth meet.
2. How much room each dental arch has.
3. Whether the jaw shifts sideways as the teeth close.
4. The facial profile and jaw relationship.

Two children with similar-looking smiles may need different treatment because their bites or patterns of growth differ.

The habits that change the advice

Thumb sucking can affect tooth position, while mouth breathing or snoring may warrant further discussion. Mention what you notice at home, including difficulty chewing. These observations give the orthodontist information that a brief exam alone may not reveal.

What happens after the visit, including the records appointment

In some offices, diagnostic records are taken at a separate appointment. A firm treatment recommendation and price wait until the orthodontist has reviewed the X-rays and scan.

For a young child, the next step is another check in six to twelve months, not immediate treatment. That allows the orthodontist to monitor growth and the arrival of permanent teeth.

When treatment is recommended, the start date is often one to several weeks after the consultation. The timing depends on the records review and on whether a custom appliance needs to be made.

Many offices offer the first consultation free, while others bill it as a diagnostic visit. Dental plans with orthodontic benefits often cover part of that cost. Ask whether X-rays and scanning are included, and whether a separate records appointment carries a charge. Review our financial information page, then confirm costs and insurance benefits for your situation.

Our orthodontic FAQs cover additional questions about treatment.

How often you come back once treatment starts

Adjustment visits fall several weeks apart, set by the appliance and the stage of treatment. Before agreeing to a plan, ask how often you will need to come in and how those visits fit around school or work.

A broken bracket or missing aligner should prompt a call rather than a wait until the next appointment. Orthodontic wax can cover a poking wire temporarily. Our emergency care page explains common appliance problems and what to do while seeking guidance.

For everyday questions about eating and cleaning, use our life with braces guide.

Frequently asked questions

Is the first orthodontist visit painful?

The exam is usually not painful, and a consultation does not involve drilling or tightening braces. X-rays require you to hold still briefly. Tell the team beforehand about anxiety or anything that has made previous dental appointments uncomfortable.

Does the first visit involve impressions or scans?

We use iTero digital scanning instead of putty impressions. A handheld wand records your teeth to create a three-dimensional model. Confirm whether scanning is scheduled for your consultation or a separate records visit.

Will braces go on at the first visit?

Braces are not placed during the initial consultation. The orthodontist first needs enough information to recommend treatment, and custom appliances require preparation. Ask when treatment could begin once your records have been reviewed.

How often will I need appointments after treatment starts?

Follow-up visits run several weeks apart, and your appliance and treatment stage set the interval. Ask for the expected schedule before starting so you can plan around work or school.

Is the first visit free, and what is billed separately?

Confirm the fee before booking rather than assuming the consultation is free. Ask whether the X-rays and any separate records visit are included. Call our Blue Bell office at (215) 367-5385 or Lower Merion office at (610) 667-6770, or submit an Appointment Request form and ask what your first visit will include.