The American Association of Orthodontists recommends that every child first visit an orthodontist by age 7 or earlier if a problem is detected by parents, the family dentist or the child's physician. The first permanent molars and incisors have usually come in by that time and crossbites, crowding and other problems can be evaluated. When treatment is begun early, the orthodontist can guide the growth of the jaw and guide incoming permanent teeth. Early treatment can also regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce likelihood of impacted permanent teeth, correct thumb-sucking, and eliminate abnormal swallowing or speech problems. Early treatment may also be indicated in situations where severe crowding or spacing is causing the patient emotional distress. In other words, if needed, early treatment can simplify later treatment. When early treatment is indicated children are usually treated in two phases.