If someone asked you to describe what you think of when you hear the term “orthodontics,” the chances are good that it would include some combination of metal braces and a tween or teen. This is a pretty persistent stereotype, so it can be surprising to learn that the American Association of Orthodontists recommends a child have their first orthodontic evaluation around the age of seven. Since we tend to associate orthodontics with braces, and braces with teens, seven can seem young. After all, most kids will still have baby teeth and developing mouths at this age. But as it turns out, that’s actually the point!

When a child is examined at a younger age by an experienced orthodontist like Dr. Zeifman, there’s a much better chance of catching potential orthodontic issues early. This means that problems can be addressed and corrected before they’re able to have a negative impact on their future permanent teeth. We treat a number of young patients here at Zeifman Orthodontics, and as a result, we’re big believers in the power of preventive care! Time and again, we’ve seen that starting treatment at the right time can make a positive difference to a child’s oral health.

Do you have a child around seven years of age who is ready for their first orthodontic appointment? If so, we’d love to meet you both and check for a number of issues to determine if orthodontic treatment is indicated now, or may be necessary in the future. To learn more about what we’ll be looking for and why an early orthodontic evaluation is so important, keep reading below!

Tooth Loss and Eruption

As the placeholder for permanent teeth, baby teeth are important even though they fall out. Where they’re located and when a child loses them matters more than you might imagine. Because the primary teeth tend to fall out in a fairly specific order, a significant deviation from this pattern could signify a developmental issue that may need our attention.

By the time they’re seven years old, children should have at least four permanent molars and up to four permanent incisors. If your child has more or less than this, it could indicate a problem with missing, crowding, or extra teeth. When this happens, we may choose to remove a primary tooth early, or we may want to maintain a space where a tooth has been lost prematurely in order to prevent problems later on.

Dr. Zeifman showing teeth to young patient

Crowding and spacing

An experienced orthodontist like Dr. Zeifman will be able to tell early on in your child’s life if there are already issues with excessive crowding or spacing of their teeth. She will also be able to tell if such problems are likely to develop later on. Spacing issues can show up when a tooth is lost prematurely, where one has never developed, or with teeth that are too small or spaced apart. If crowding turns out to be an issue, it can often be corrected by expanding the arches or removing certain teeth.


Although teeth can be successfully aligned at almost any age – over a quarter of current orthodontic patients are over the age of eighteen! – correcting crooked teeth at an earlier age gives your child the best start on a healthy smile. Crooked teeth are more susceptible to uneven damage and wear, and if they are left untreated over a long enough period of time, it can affect the shape and position of the surrounding gum tissue by compromising it.

Overbite (protrusive front teeth)

While a child’s cosmetic appearance may be the most obvious concern with protruding front teeth, they can also cause pain in the jaw along with possible speech issues. While we aren’t always able to permanently correct an overbite until your child’s mouth has finished growing, there are still a number of things we can do to help reduce the risk of traumatic injury. Doing so tends to make things easier for children psychosocially as well!


Underbites may be caused by problems with either the teeth or jaws. The most difficult scenario involves the lower jaw growing too far forward, and if this occurs, we’ll typically need to wait until the patient has finished growing to begin their treatment. This will normally be by about age 16 or so. Even if there’s a waiting period involved, early treatment is still important in order to avoid bite-shifting and damage to the front teeth. There are various methods we can use to try and normalize the bite as early as possible. This includes something called “jumping the bite,” where we use braces or appliances to get a start on a young child’s underbite before completing treatment in their teen years. Underbite patients who receive early treatment (between the ages of 7-10) are much less likely to need corrective jaw surgery when they get older.

Posterior Crossbite

A posterior crossbite can cause crowding, and may also cause the jaw to shift from one side to the other. When we’re able to expand the upper jaw in earlier childhood, we can reduce crowding and create space for the front teeth to come through uninterrupted. Expansion can also eliminate any shifting that may be present due to a constricted upper jaw.

Anterior Open Bites and Deep Bites

These bite problems occur vertically, and can usually be spotted by the time a child is ready for their first orthodontic appointment. In bites that are too deep, the top teeth completely cover the bottom ones when biting, which can indicate a small lower jaw. In an open bite, the overall bite doesn’t overlap enough, which may be a sign that there is a finger, thumb, or tongue habit causing dental problems. If this is the case, we’ll be happy to work with you and your child to eliminate any destructive habits early on so their development can continue normally.

Dr. Zeifman talking to a young boy patient

Early evaluations result in healthier smiles with Zeifman Orthodontics

Early orthodontic evaluations give your child the best chance for a healthy smile that will last a lifetime! The jaw bones begin to harden in a child’s teen years and will eventually stop growing. Any orthodontic procedures performed after this point, such as tooth extractions or oral surgery, will often take more time and be more invasive. If a child receives early orthodontic care, it can help prevent the need for orthodontics as an adult, reducing the need for further treatment. Interceptive treatment like early evaluations can make comprehensive orthodontic treatment faster and more effective.

At Zeifman Orthodontics, your child’s smile will be our number one priority. We’ve created a friendly environment that will make you feel welcome and at-home from the moment your family walks in our door, and we do our best to provide a positive, stress-free orthodontic experience. Our talented team is known for offering the highest quality orthodontic care for patients of all ages in Florham Park and the surrounding communities. If you’re ready to schedule your child’s first orthodontic appointment, get in touch with us today and take the first step towards a beautiful, healthy smile.