The typical time to start orthodontic treatment is when all of the permanent teeth have erupted. In the adult presented below, a very crowded bite is present with flaring of the upper teeth. Notice that several teeth have erupted off the arch.

ABOVE: A photograph of an adult with severe crowding and protrusion of the upper teeth compared to the lower teeth. The teeth are blocked out of the arch and have erupted outside the bony ridge provided for the teeth.

ABOVE: A photograph of the same adult after widening of the arch has occurred. Note that the gums are healthier.