If your child’s dentist mentioned an orthodontic evaluation — or you have noticed crowded teeth, an off bite, or a thumb-sucking habit that will not quit — you are asking exactly the right questions at exactly the right time. In Montgomery County, where school pictures and self-confidence matter to families, children’s orthodontics is one of the most common reasons parents seek out a specialist. The good news: an early visit is low-pressure, usually free, and rarely means braces are going on tomorrow.

The magic number is 7

The single most useful fact for parents is this: the American Association of Orthodontists recommends a first orthodontic check-up no later than age 7 (AAO). That can feel early — most kids still have a mouthful of baby teeth at 7 — but that is exactly the point. By age 7 enough permanent teeth and jaw growth have emerged for a specialist to spot how the bite is developing, while there is still plenty of growth left to guide.

An age-7 visit is a screening, not a sentence. In most cases the orthodontist simply confirms that everything is on track and recommends periodic check-ups. This “watchful waiting” is free at most local practices and lets the orthodontist step in at the ideal moment — not too early, not too late.

The timeline of children's orthodontic care from age 7 onward A timeline showing a first check-up at age 7, an optional early Phase I treatment around ages 8 to 10, a monitoring period, and comprehensive Phase II braces around ages 11 to 14. When kids' orthodontics happens Age 7 8–10 11–14 Teens First visit Optional Phase I Phase II (full braces)
Most children are simply monitored after the age-7 visit; only some need early Phase I treatment. Full braces, when needed, usually come once most permanent teeth are in. Source: American Association of Orthodontists.

Signs your child might need an evaluation

You do not have to wait for a dentist to raise it. Consider booking an orthodontic evaluation if you notice any of these:

  • Crowded, crooked, or overlapping teeth as permanent teeth come in
  • An underbite, overbite, or crossbite — the teeth or jaws meet in a way that looks off
  • Difficulty chewing or biting, or teeth that do not meet properly
  • A thumb- or finger-sucking habit past about age 5, which can push teeth and reshape the palate
  • Mouth-breathing, or the jaw shifting or making sounds
  • Baby teeth lost unusually early or late, or permanent teeth erupting out of place

None of these are emergencies, and none guarantee braces. They are simply reasons to let a specialist take a look while guiding growth is easiest.

Early (Phase I) vs. comprehensive (Phase II) treatment

Children’s orthodontics sometimes happens in two stages, and understanding the difference saves a lot of worry:

  • Phase I (early, or interceptive) treatment happens around ages 8–10, while baby and permanent teeth are mixed. It targets a specific problem — a crossbite, a narrow palate, severe crowding, or a protrusion at risk of injury — often with a partial set of braces or an expander. Only a minority of children need it, but for those who do, it can reduce or simplify later treatment.
  • Phase II (comprehensive) treatment is the “classic” full set of braces or aligners, usually starting around ages 11–14 once most permanent teeth are in. This is where the bite and alignment are finished for good.

Many children skip Phase I entirely and go straight to a single course of comprehensive treatment as teens. A good orthodontist recommends the least intervention that gets the right result — be cautious of anyone pushing early braces without a clear, specific reason.

A young patient smiling in an orthodontist's chair during a check-up
The age-7 visit is a low-pressure screening. A good orthodontist recommends the least intervention that gets the right result. (Image: Pexels)

Braces vs. Invisalign for kids and teens

For teens, clear aligners are now a real option alongside traditional braces. Invisalign offers a teen product with features built for growing mouths, and aligners suit many straightforward cases. But removable aligners only work if they are worn 20–22 hours a day — so for a younger child, a complex bite, or a kid who will forget, dependable fixed braces are often the better choice. For a deeper side-by-side on cost and case suitability, see our guide to Invisalign vs. braces in Bethesda and Rockville, which covers both adults and teens.

What children’s braces cost in Montgomery County

Local 2026 pricing for children generally runs about $3,500–$6,000, depending on the treatment type, complexity, and length. Early Phase I treatment is usually less, because it is shorter and more limited in scope. A few planning notes specific to families:

  • Insurance is friendlier to kids. Where adult orthodontic coverage is often thin, many Maryland dental plans include a child orthodontic benefit — commonly a lifetime maximum of about $1,000–$2,000. Maryland Medicaid/MCHP may also cover orthodontics for children when it is medically necessary (severe cases scored on a handicapping-malocclusion index), not for purely cosmetic reasons.
  • FSA/HSA dollars can typically be applied, and nearly every local practice offers interest-free monthly payment plans.
  • For the full statewide picture by treatment type, see our detailed guides to how much braces cost in Maryland in 2026 and how much Invisalign costs in Maryland in 2026.

Do we need a specialist, or can our dentist do it?

For children, this matters more than it does for adults. Guiding a growing jaw, timing treatment to development, and managing expanders or early appliances are core to an orthodontist’s two to three years of extra specialty training after dental school. A family dentist is perfect for cleanings and simple cases, but a developing bite is exactly where a specialist earns their keep. Our guide on the difference between an orthodontist and a dentist for braces in Maryland explains which one your case calls for.

Where to start locally

When you are ready for that first evaluation, a board-certified specialist who works with children is the right first call:

  • Dr. Atefeh Boroun at Fallsgrove Orthodontics in Rockville — board-certified, graduated first in her dental class, with a 4.9 Google rating.
  • Dr. Richard Shin — a husband-and-wife, board-certified orthodontic team in Potomac’s Cabin John Village.
  • Dr. Eduardo Avila on Rockville Pike, known for taking on complex cases other offices decline.
  • Dr. Mehdy Rad with family-friendly offices in Bethesda and Potomac, and Dr. Jean Hong, a specialist with 20+ years running her own Silver Spring practice.

From there:

The bottom line for parents: book the age-7 screening, expect monitoring rather than immediate braces, and lean on a specialist to time treatment right. Starting the conversation early is free — and it is the surest way to keep your child’s treatment shorter, simpler, and less expensive down the road.

Sources & further reading