Treatment will not usually commence until the child is about 12 or 13 years old; when the adult teeth have come through and developed fully. In some cases treatment may start a couple of years later if teeth problems had not become noticeable beforehand.

Children with a cleft lip and palate may require orthodontic treatment before their adult teeth have developed completely.

Good oral hygiene is essential before any orthodontic work can begin. When devices are placed on the teeth, bits of food are much more likely to become stuck; the patient will need to brush much more carefully and more often to prevent tooth decay while treatment is ongoing.

Patients who have not reached good oral hygiene standards beforehand are much more likely to suffer from tooth decay after treatment begins.