Does your seven-year-old really need braces?

• Position: Pediatric Dentistry

Braces often are a rite of passage for middle-school students with overbites or crooked teeth, but the oral problems those braces are solving likely started way back in elementary school--possibly as early as first or second grade. So, perhaps it should not be a surprise that the American Association of Orthodontists, St. Louis, Mo., recommends children make their first visit to an orthodontist no later than age seven.

"That doesn't mean they are going to get braces," relates Jamie Reynolds, an orthodontist, lecturer, and author of World Class Smiles, Made in Detroit: The Straight-Shooting Orthodontist's Guide to Your Amazing Smile. "In fact, it's pretty unusual to put braces on a child that young."

However, with those early visits, the orthodontist might be able to head off problems before they get worse. Reynolds says these are a few of the things an orthodontist would be checking with your child:

Are the jaws growing properly? "You would think the upper jaw and the lower jaw grow pretty much in tandem, but you would be wrong. The upper jaw stops growing around age eight, while the lower jaw keeps on growing like the rest of the body. That means orthodontists can spot problems with the upper jaw earlier and recommend treatment if needed."

Is there enough room for the teeth to grow in? "Sometimes permanent teeth do not have enough room to grow in properly, possibly because a baby tooth is in the way. Generally, baby teeth fall out on their own but, occasionally, a stubborn one needs to be pulled so that the permanent tooth does not start growing in an awkward direction and become impacted. Removing a misbehaving baby tooth is often the simplest and best solution to a problem that could become much...