Reviewed by Dr. Corina Radu, Board-Certified Orthodontist
Two-phase treatment splits orthodontic care into two stages. The first phase takes place while a child is still growing and focuses on guiding the jaws and making room for permanent teeth. The second phase begins once the permanent teeth have come in and straightens them into their final positions.
At Premier Orthodontics & Dental Specialists, Dr. Corina Radu uses this approach to correct jaw and bite problems early, when they’re easier to treat, and finish with a straight, healthy smile. Not every child needs two phases, and your free consultation will show whether this approach is right for your child.
What is the advantage of two-phase orthodontia?
Not every child will need two distinct orthodontic phases of treatment. In fact, studies have shown that there is no difference between results achieved treating children in two phases versus one phase, provided that no intervention is needed early. The American Association of Orthodontists recommends that every child have an orthodontic consultation by age 7. We can tell if they are crowded or spaced, if dental development is normal or delayed, and if growth is normal or potential bite problems are developing.
Orthodontists are specialists trained to look for abnormal patterns such as underbites, overbites with risk of trauma, crossbites and asymmetries. In addition, we evaluate swallowing, breathing patterns and harmful habits, and try to look into the future. Scanning the whole dentition with a digital low-dose panoramic radiograph provides tremendous information about unerupted teeth.
Sometimes we see surprises such as pathology, cysts, extra teeth, congenitally missing teeth or impactions. We educate the parents and propose treatment options such as expanders, partial braces, habit correctors or baby teeth extractions, in combination with fixed or removable appliances and whatever else is needed to help that particular child.
What if treatment is put off?
Putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your son’s or daughter’s smile. Early treatment is most effective for achieving lasting results and preventing more serious complications. Some parents resist having X-rays taken or having primary teeth extracted, or they postpone creating space until later.
The problems will not disappear; usually, they become worse. Impacted teeth can take a wrong turn and damage or dissolve the roots of neighboring adult teeth, to the point that some may become severely compromised and lost in the future. Like everything else in medicine, prevention is much easier and less expensive than dealing with the aftermath of not starting treatment at the right time.
Phase One
— A Foundation for a Lifetime of Beautiful Smiles
The goal of Phase I treatment is to help create more balanced arch development for the incoming permanent teeth to erupt, whether that means using expanders or partial braces in one or both jaws, or breaking bad habits. As mentioned, many children show early signs of jaw problems as they grow and develop, well before they are ready for a full set of braces.
In my own family, two of my children needed Phase I. One needed an expander and partial upper braces to relieve crowding. The other was growing into an underbite and needed a bonded expander with hooks for a reverse-pull facemask. Both completed Phase I in less than a year and needed full braces or aligners once the remaining permanent teeth came in.
For various timing, financial and insurance reasons, some patients come in for treatment much later in life, and we hear ourselves saying, “I wish I had met you earlier, so I could have expanded your jaw before you finished growing and prevented extractions, surgery or impactions.”
- Planning now can save your child’s smile later. Children benefit tremendously from early-phase treatment. Receiving early treatment may prevent the removal of permanent teeth later in life, or the need for surgical procedures to realign the jaws.
- Making records to determine your child’s unique treatment. Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment and the frequency of visits. Records consist of models of the teeth, X-rays and photographs. During your child’s initial consultation, we will take records to determine whether early treatment is necessary.
Resting Period
In this phase, the remaining permanent teeth are left alone as they erupt. Retaining devices may not be recommended if they would interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement.
A successful first phase will have created room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.
- Monitoring the teeth’s progress. At the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually every six months.
Phase Two
— Stay healthy and look attractive
At the beginning of the first phase, orthodontic records were made, and a diagnosis and treatment plan were formulated and carried out. Certain types of appliances were used in the first phase to correct and realign the teeth and jaws.
Now that all permanent teeth are in, new records and goals are needed. Most often, this phase is about fine-tuning the position of individual teeth, creating a good bite and achieving a beautiful, healthy smile. Whether this is done with traditional metal or clear braces, clear aligners or SureSmile aligners, the patient and parents can choose the most appropriate treatment. In some cases, having had Phase I treatment may reduce the overall length of Phase II comprehensive orthodontics. Retainers, whether fixed, removable or a combination, will need to be worn after this phase to make sure your child keeps their beautiful smile for years to come.
Why Should You Chose Premier Orthodontics and Dental Specialists for your child two phase Orthodontic treatment?
- Because we are energetic, straightforward, focused and working for you, the patient!
- We are ethical, transparent, flexible and more affordable than you think.
- We will do everything we can to make treatment affordable for families in need. I have seen problems like these too many times not to work with a parent and make it work, whether that means lowering the overall fee or stretching the payments. We are seriously here to help!
- Please don’t wait for a referral to schedule an evaluation. The best time to treat certain problems can pass quickly, and many dentists bring their own children to orthodontic specialists. For your peace of mind, your first consultation with us is free.
- Be treated by an experienced orthodontist. There is no substitute for experience, both in efficiency and in the quality of treatment!
At Premier Orthodontics & Dental Specialists, we understand that everyone has different needs. If you’re unsure, get a second opinion from another board-certified orthodontist. In many cases, I place patients on observation and ask parents to bring their children back once most of the permanent teeth have come in, because not every child who walks into my office needs orthodontic treatment right away.