What D8660 means

D8660 covers a pre-orthodontic treatment examination to monitor growth and development. "D" is dental, "86" is the orthodontic adjunctive group, and "60" is this pre-treatment visit. It's used for the evaluation and monitoring done before active orthodontic treatment starts — assessing a patient's teeth, jaws, growth, and development to determine whether orthodontic treatment is needed and, importantly, when the right time to begin would be. It's particularly used for children who have been identified as likely needing orthodontics but aren't yet at the optimal stage to start (for example, still waiting for permanent teeth to erupt).

These visits allow the orthodontist to track the patient's development over time — monitoring tooth eruption, jaw growth, and the developing bite — so treatment can be timed appropriately. Rather than starting too early or missing the ideal window, the pre-orthodontic monitoring ensures treatment begins when it will be most effective.

D8660 is distinct from the comprehensive treatment codes (D8080/D8090) and from the periodic visits during active treatment (D8670). It's the 'before treatment' assessment and monitoring phase. It's sometimes called a recall or observation visit in orthodontics. Coverage varies — some plans cover it, others bundle or don't cover pre-treatment monitoring.

When it's typically used

D8660 is reported for a pre-orthodontic evaluation or monitoring visit — assessing whether orthodontic treatment is needed and determining the right timing to begin, often for a child being observed as they grow before starting braces.

How much does D8660 cost?

A pre-orthodontic visit is a modest fee, often roughly 50 to 150 USD per visit depending on region — much less than active treatment. Many orthodontists offer an initial consultation at low or no cost, with periodic monitoring visits (for a child being observed) being inexpensive.

Is D8660 covered by insurance?

Coverage varies; some plans cover pre-orthodontic examination visits, others bundle them with later treatment or don't cover monitoring separately. Since it's part of determining orthodontic need and timing, coverage may relate to the plan's overall orthodontic benefit. Many initial consultations are offered free by orthodontic offices regardless of insurance.

Why orthodontic timing matters

The pre-orthodontic visit exists largely because timing is important in orthodontics, and understanding why explains the value of monitoring before treatment.

Starting orthodontic treatment at the right time can make it more effective, sometimes simpler, and occasionally can prevent problems from worsening. For children, the developing teeth and growing jaws create windows of opportunity: some problems are best addressed early (interceptive treatment) while the child is growing and the issue is developing, while comprehensive treatment is usually best timed for when all (or most) of the permanent teeth have erupted. Starting too early might mean treating before the situation is ready; waiting too long might miss a chance to use growth to help a correction, or let a problem worsen. The ideal timing depends on the specific issue and the child's individual development.

This is why monitoring a child's growth and development before treatment is valuable. By periodically evaluating how the teeth are erupting and the jaws are developing, the orthodontist can identify the optimal moment to begin treatment for that child — not too early, not too late. The pre-orthodontic visits (D8660) are this monitoring. They ensure that when treatment does start, it's at the point where it will be most effective and appropriate, which can improve results and sometimes reduce the complexity or duration of treatment. Getting the timing right is a real benefit of pre-treatment orthodontic assessment.

What happens at a pre-orthodontic visit

Knowing what a pre-orthodontic evaluation involves helps clarify what these 'before treatment' visits accomplish.

At an initial orthodontic consultation, the orthodontist examines the patient's teeth, bite, and jaw relationships, often taking records like photographs, X-rays (such as a panoramic and sometimes a cephalometric X-ray), and possibly digital scans or impressions. They assess what orthodontic issues are present (crowding, spacing, bite problems like overbite or crossbite, etc.) and discuss whether treatment is needed. For a child not yet ready to start, the orthodontist determines the best timing and may recommend periodic monitoring visits to track development until the right moment to begin treatment. At these follow-up monitoring visits, the orthodontist checks the progress of tooth eruption and jaw growth, updating the assessment of when to start.

These visits are evaluative rather than active treatment — no braces are placed; the focus is on assessment, planning, and timing. For the patient and parents, it's an opportunity to understand the orthodontic situation, ask questions, and learn the plan, including roughly when treatment would begin and what it would involve. The pre-orthodontic phase essentially sets the stage for successful treatment by ensuring it's well-planned and well-timed. For a child being monitored, these periodic check-ins (often every several months to a year) continue until the orthodontist determines it's time to start, at which point treatment transitions to the active phase.

When should a child first see an orthodontist?

A common question for parents is when to first take a child to an orthodontist, and the recommendation is often earlier than people expect.

Many orthodontic organizations recommend that children have an initial orthodontic evaluation around age 7. This doesn't mean treatment will start then — most children aren't ready for braces at that age — but rather that an early evaluation allows the orthodontist to assess the developing teeth and jaws, identify any issues that are emerging, and determine whether early (interceptive) treatment would be beneficial or whether to simply monitor and time comprehensive treatment for later. By age 7, the first permanent molars and incisors have typically come in, giving the orthodontist enough to evaluate the developing bite and spot potential problems.

For most children, the evaluation leads to a recommendation to monitor development (the pre-orthodontic phase) until the right time for treatment, often in the early-to-mid teens. For some, early interceptive treatment is recommended to address a specific developing problem. Either way, the early evaluation is valuable for catching issues and planning the timing. Parents don't need to wait until all the permanent teeth are in or until a problem is obvious; an early orthodontic check-up (around age 7, or whenever a concern arises) provides peace of mind and ensures any treatment is well-timed. Many orthodontists offer these initial consultations at little or no cost, making early evaluation accessible.

Early (interceptive) vs comprehensive treatment

The pre-orthodontic assessment often determines whether a child needs early treatment or should wait for comprehensive treatment, and understanding the difference clarifies the options.

Early or interceptive orthodontic treatment (sometimes called Phase 1) is done in younger children, while they still have some baby teeth and are growing, to address specific developing problems — for example, correcting a crossbite, creating space for crowded teeth, guiding jaw growth, or addressing a harmful habit. The goal is to intercept a problem early, taking advantage of growth, which can simplify or sometimes reduce the need for later treatment. Comprehensive treatment (Phase 2, coded D8080/D8090) is the full course of braces done once the permanent teeth are in, to align everything and perfect the bite. Some children need only comprehensive treatment; some benefit from early treatment followed later by comprehensive treatment; and some need only early treatment or none.

The pre-orthodontic evaluation and monitoring (D8660) is how the orthodontist determines which path fits a child. By assessing the developing situation, they decide whether to intervene early, monitor and wait for comprehensive treatment, or both. This individualized planning ensures the child gets the right treatment at the right time. For parents, understanding that orthodontics may involve early treatment, comprehensive treatment, or a combination — depending on the child's specific needs — helps make sense of the orthodontist's recommendations. The pre-treatment monitoring is what guides these decisions, tailoring the approach to each child's development.

Frequently asked questions

What is the D8660 dental code?

It's a pre-orthodontic treatment visit — an evaluation to assess whether and when orthodontic treatment is needed, before treatment begins, including monitoring a child's growth to determine the right timing for braces.

What happens at a pre-orthodontic visit?

The orthodontist examines the teeth, bite, and jaws (often with X-rays and records), assesses what treatment is needed, and determines the best timing — monitoring a child's development if they're not yet ready to start.

When should a child first see an orthodontist?

Often around age 7, for an initial evaluation — not necessarily to start treatment, but to assess development, catch emerging issues, and plan the right timing for any treatment.

How much does a pre-orthodontic visit cost?

Often around 50 to 150 USD per visit, much less than active treatment. Many orthodontists offer the initial consultation at low or no cost.

Why does orthodontic timing matter?

The right timing makes treatment more effective and sometimes simpler — some problems are best addressed early during growth, while comprehensive braces are usually timed for when the permanent teeth are in.

What's the difference between early and comprehensive treatment?

Early (interceptive) treatment addresses specific developing problems in younger children during growth. Comprehensive treatment is the full course of braces once the permanent teeth are in. The pre-ortho visit determines which is needed.

This page is an independent, plain-language explanation for general information only. It is not billing, coding, or clinical advice. For the official CDT descriptor and current-year wording, refer to the American Dental Association.