Medically Reviewed by Dr. Hollander on September 28, 2026
If you have noticed your child’s teeth coming in crowded, crossing over each other, or shifting your child’s jaw to one side when biting down, you are probably wondering when to start paying attention to it. Many parents assume orthodontic concerns are something to worry about later, once all the permanent teeth have arrived, and braces become the obvious next step.
The truth is earlier evaluation often leads to simpler treatment down the road. At Pediatric Dentistry of San Jose, we combine general pediatric dental care with an on-site orthodontist, so Berryessa families can address alignment concerns without being sent elsewhere for a second opinion.
Why Early Orthodontic Evaluations Matter
The American Association of Orthodontists recommends every child have an orthodontic evaluation no later than age 7. At this age, a mix of baby teeth and permanent teeth gives our team enough information to spot developing bite issues, even when a child’s smile looks fine to an untrained eye.
An early evaluation does not mean your child needs braces right away. Most children who come in around this age simply need monitoring, with a follow-up visit scheduled for a later date. The goal is catching potential concerns while your child’s jaw is still growing, since some issues become more complicated to correct once growth has finished.
Signs Your Child May Benefit From an Evaluation
Some orthodontic concerns are easy to spot at home, while others only become clear during a professional exam. Watching for a few common signs can help you decide whether it may be time to schedule a visit.
Consider bringing your child in if you notice any of the following:
- Crowded or overlapping teeth: Permanent teeth coming in at odd angles or on top of one another.
- Jaw shifting when biting: The lower jaw moving to one side as your child bites down.
- Prolonged thumb sucking: Habits continuing past the age when baby teeth begin falling out.
- Difficulty chewing or speaking: Trouble that seems connected to how the teeth or jaw line up.
If any of these sound familiar, an evaluation can help clarify whether watching and waiting or early treatment makes more sense for your child.
How Early Treatment Can Simplify Later Care
When a bite or jaw concern is caught early, treatment can sometimes guide how the jaw grows rather than working around a fully developed structure. This is often described as interceptive orthodontics, and it may involve simple appliances that create more room for incoming permanent teeth or help correct a shifting bite.
Dr. Hollander’s Background in Jaw Development
Dr. Zachary Hollander completed his orthodontic training and a master’s degree in Oral Biology at UCLA after earning his DDS at Columbia University. He is a Diplomate of the American Board of Orthodontics and has been published in the American Journal of Orthodontics and Dentofacial Orthopedics for his work on the Maxillary Skeletal Expander, a device used to widen a narrow upper jaw during a child’s growing years. That background means the same team that evaluates your child’s bite is also the one planning what happens next, without a referral to a separate office.
What This Looks Like for Berryessa Families
Families across Berryessa often juggle school schedules, sports, and multiple kids with different needs, so having pediatric dentistry and orthodontics under the same roof can cut down on the back and forth between offices. If your child already comes to us for cleanings and exams, an orthodontic evaluation can often happen during the same visit or a quick follow-up appointment.
We also work with families throughout Evergreen and Milpitas, and we accept most PPO dental insurance plans, which helps many parents plan for orthodontic care without added guesswork about coverage. According to the American Association of Orthodontists, waiting for a dentist referral is not necessary before scheduling an orthodontic evaluation, so parents can reach out whenever a concern comes up.
Pediatric Dentistry of San Jose Is Here for Your Child’s Smile
Whether your child is just starting to lose baby teeth or already showing signs of a developing bite issue, having pediatric dental care and orthodontics in one place makes it easier to stay ahead of what comes next. Dr. Michelle Haghpanah leads a team with Stanford hospital privileges and a practice built on more than forty years of caring for San Jose families, while Dr. Hollander brings orthodontic training from Columbia and UCLA along with published research on jaw development. Together, our team looks at your child’s full picture, from routine cleanings to orthodontic timing, rather than treating each visit as a separate concern.
If you have questions about your child’s bite, jaw growth, or whether an orthodontic evaluation makes sense right now, we are glad to walk through it with you. Our orthodontic care team welcomes new and existing patients, and most PPO dental plans are accepted. You can reach us and find a time that works for your family through our contact form.
Frequently Asked Questions About Pediatric Orthodontic Care in Berryessa
When should my child have their first orthodontic evaluation?
The American Association of Orthodontists recommends that every child have an orthodontic evaluation no later than age seven. At this age, a mix of baby teeth and permanent teeth gives our team enough information to identify developing bite issues, even when a child’s smile looks fine to an untrained eye. An early evaluation does not mean treatment will start right away. Most children who come in around this age simply need periodic monitoring rather than immediate intervention.
Does an early orthodontic evaluation mean my child needs braces right away?
No. The majority of children who have an evaluation at age seven do not need braces immediately. The goal of an early evaluation is to give our team a developmental snapshot so we can catch concerns while the jaw is still growing, which in some cases allows for simpler guidance than would be possible once growth is finished. Many children leave the evaluation with a plan to return in six to twelve months for a follow-up rather than beginning active treatment.
What is interceptive orthodontics and is it different from regular braces?
Interceptive orthodontics, sometimes called Phase 1 treatment, refers to early orthodontic intervention for children who still have a mix of baby and permanent teeth. The goal is not to complete all tooth alignment at once but to address specific structural concerns, such as a narrow upper jaw or a developing crossbite, while the jaw is still actively growing and more responsive to gentle guidance. Regular braces, or Phase 2 treatment, typically happens later and focuses on the final positioning of all permanent teeth.
Does having pediatric dental care and orthodontics in the same office really make a difference?
When pediatric dentistry and orthodontics are under the same roof, the clinical team can coordinate observations across routine cleanings, X-rays, and orthodontic evaluations without relying on separate offices to share records. This means that if our pediatric dental team notices an eruption pattern or habit worth monitoring during a routine cleaning, Dr. Hollander can review it directly without requiring a separate referral appointment. For families who are already coming in for regular checkups, it also makes scheduling easier.
Does my child need a referral from their regular dentist before seeing an orthodontist?
No. According to the American Association of Orthodontists, a referral from a general or pediatric dentist is not required before scheduling an orthodontic evaluation. Parents can reach out directly when they have a concern about their child’s bite, jaw development, or tooth positioning. At Pediatric Dentistry of San Jose, families who already come to us for pediatric dental care can also request an orthodontic evaluation from Dr. Hollander during an existing appointment or schedule one independently.
ABOUT THE AUTHOR
Diplomate, American Board of Orthodontics — Pediatric Dentistry of San Jose, San Jose, CA
Dr. Hollander is a Diplomate of the American Board of Orthodontics and holds a master’s degree in Oral Biology from UCLA. As the in-house orthodontist at Pediatric Dentistry of San Jose, he brings specialized training and a collaborative approach to every evaluation and treatment plan he develops for young patients.
