What an Orthodontic Assessment Involves, Step by Step

The visit in order

Arrival and paperwork (5 min)Medical and dental history, medications, allergies, previous orthodontic treatment, and consent for records. Bring a list of medications and any recent dental radiographs.
The conversation (10 min)What bothers you or your child, when you noticed it, habits (thumb, nail-biting, tongue posture), snoring or mouth-breathing, injuries to the teeth, and what you hope treatment would change. This shapes the plan more than people expect.
The examination (10 min)Face and profile at rest and smiling; how the jaws open, close and slide; the bite from the front and each side; each tooth; gum health; the airway and tonsils as a screening observation only.
Records (15 min)Photographs of the face and teeth; a digital scan that builds a 3D model (no impressions at the recommended clinic); a panoramic radiograph and, if treatment is likely, a side-view cephalometric radiograph. Radiographs are taken when they will change the decision.
The discussion (15 min)What the orthodontist sees, what the options are, and one of the three outcomes below. For a proposed plan, expect a written summary and quote, either at the visit or shortly after.

The three outcomes

What the assessment can conclude
Outcome	What it means	What you should leave with
Nothing needed	The bite and development are within normal range, or an issue is minor enough not to treat	A note of what was checked, and when (if ever) to return
Monitor	Something specific is worth watching, usually eruption or growth, and the right time to act is later	What is being watched, and a return interval (often 6 to 12 months)
Treatment proposed	A problem that treatment would help, now or after some growth	The goal, the appliance, a duration range, what you have to do, what could change the plan, and a written quote with inclusions

What to bring, and what to ask

Before the visit

Recent dental radiographs, if your dentist has them (they can often be emailed).
A list of medications and any medical conditions, including asthma inhalers and bleeding disorders.
For a child: notes on habits, snoring, mouth-breathing and any dental injuries.
Your questions. The three that matter most for treatment life: what will I have to do every day, how are emergencies handled, and what does the fee include?
Extended health plan details if you have orthodontic coverage; the clinic can help with predeterminations.

Questions about the provider (their credentials, how to compare quotes, when a second opinion is worthwhile) are a separate subject with a separate guide: what to ask an orthodontist at a consultation on SurreyOrthodontist.com.

What is not part of a good assessment

A quote before records. A fee for an unexamined mouth is a guess.
Starting treatment the same day unless you asked for that and the case is simple.
A promise about breathing, sleep, headaches or posture. An orthodontist can note observations and suggest a medical referral; diagnosis of those conditions is medical.
Pressure. A treatment plan is valid for months; take it home.

A note on airway and sleep. Orthodontists assess growth, jaws, bite, arches and habits. Physicians diagnose medical sleep and airway disorders, and orthodontic treatment is not a treatment for sleep apnea, snoring, mouth breathing or attention difficulties. Where a growth pattern or habit may be relevant to breathing, a good assessment says so and suggests a medical referral rather than promising an outcome. For the national evidence summary, see AirwayOrthodontics.ca.

Why this matters clinically

Records exist so that the plan is based on measurements rather than impressions. The cephalometric radiograph, for example, shows whether prominent front teeth are a tooth problem or a jaw problem, which changes whether elastics, a growth appliance, extractions or surgery is the right answer. Taking radiographs only when they change the decision keeps radiation exposure to what is justified.

Questions people ask

Do I need a referral to see an orthodontist in BC?

No. You can book directly. Many families come via their dentist, and the clinic will send findings back to the dentist with your permission.

Are radiographs safe for children?

Modern digital panoramic and cephalometric radiographs use very low doses. They are taken when they will change the decision, not by default.

How long is a treatment plan valid?

The findings hold for months; growth can change a child's plan within a year. A quote is usually honoured for a stated period; ask.

References

American Association of Orthodontists. Your child's first check-up with the orthodontist: no later than age 7. Consumer guidance. https://aaoinfo.org/
Canadian Association of Orthodontists. Consumer information on orthodontic treatment and specialist care. https://www.cao-aco.org/
Proffit WR, Fields HW, Larson BE, Sarver DM. Contemporary Orthodontics, 6th edition. Elsevier, 2019.
Behrents RG, Shelgikar AV, Conley RS, et al. Obstructive sleep apnea and orthodontics: An American Association of Orthodontists White Paper. American Journal of Orthodontics and Dentofacial Orthopedics 2019;156(1):13-28.e1. https://doi.org/10.1016/j.ajodo.2019.04.009

What an orthodontic assessment involves, step by step

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