The American Dental Association recommends that a child visit the family dentist by his or her first birthday, while baby (primary) teeth are emerging. By seeing a child early, your dentist can see how teeth and jaws are developing, and can alert you to changes that might occur as your child grows.

Early childhood is an excellent time to lay the foundation for a lifetime of good dental habits. But good dental health means more than the health of individual teeth and the gums. To get a smile that's good for life, your child needs teeth and jaws that are properly aligned-in other words, a healthy bite.

For these reasons, the American Association of Orthodontists recommends that your child get an orthodontic check-up no later than age 7. While your child's teeth may appear to be straight, there could be a problem that only an orthodontist can detect. Of course, the check-up may reveal that your child's bite is fine, and that can be comforting news.

Even if a problem is detected, we may not recommend immediate treatment. Chances are, we will take a "wait-and-see" approach, checking on your child from time to time as the permanent teeth come in and the jaws and face continue to grow. For each patient who needs treatment, there's an ideal time for treatment to begin in order to achieve the best results. The orthodontist is the specialist who has the knowledge to determine when the time is just right.

In some cases, we might find a problem that can benefit from early treatment. Early treatment may prevent more serious problems from developing, and may make treatment at a later age shorter and less complicated. Typically, early treatment involves the use of orthodontic appliances, which may be removable, to guide the growth of young bones and create a better environment for adult teeth as they emerge. In some cases, we will be able to achieve results that wouldn't be possible once the face and jaws have finished growing. Early treatment gives us the chance to:

• guide jaw growth
• lower the risk of trauma to protruded front teeth
• correct harmful oral habits
• improve appearance and self-esteem
• guide permanent teeth into a more favorable position
• improve the way lips meet

It's not always easy to tell when your child has an orthodontic problem. Even teeth that look straight may be hiding a problem bite, and that's why it's important to take your child for that first orthodontic check-up no later than age 7.

Here are some clues that may indicate the need for orthodontic attention:

• Early or late loss of baby teeth
• Difficulty in chewing or biting
• Breathing through the mouth
• Thumb-sucking
• Crowded, misplaced or blocked-out teeth
• Jaws that are too far forward or back
• Biting the cheek or biting into the roof of the mouth
• Protruding teeth
• Upper and lower teeth that don't meet, or meet in an abnormal way
• An unbalanced facial appearance
• Grinding or clenching of the teeth

In addition to improving oral health, orthodontic treatment can provide the confidence that comes with a healthy, attractive smile for years to come. And you may be pleasantly surprised to find how affordable such a great investment can be. We will work with you to arrive at a payment plan that fits within your budget. In addition, many dental insurance plans now include orthodontic benefits.

Dollar for dollar, when you consider the lifetime benefits of orthodontic treatment, it is truly a great value.

Dr. Gittess is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities. All orthodontists are dentists, but only about six percent of dentists are orthodontists. Admission to orthodontic programs is extremely competitive and selective.

It takes many years to become an orthodontist and the educational requirements are demanding.

An orthodontist must complete college requirements before starting a three- to five-year graduate program at a dental school accredited by the American Dental Association (ADA). After dental school, at least two or three academic years of advanced specialty education in an ADA-accredited orthodontic program are required to be an orthodontist. The program includes advanced education in biomedical, behavioral and basic sciences. The orthodontic student learns the complex skills required to manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics).

Only dentists who have successfully completed these advanced specialty education programs may call themselves orthodontists.

Dr. Gittess is Certified as a Diplomate of the American Board of Orthodontists, an orthodontist with special recognition by other orthodontists.