Two-Phase Orthodontic Treatment

Two-phase orthodontic treatment, also called “Early or Phase I Treatment”,  is a specialized process that takes advantage of a critical period of jaw growth to maximize the potential for successful tooth and jaw alignment in the future.  In some cases, correcting tooth and jaw positioning early on encourages more satisfactory dental and facial development during the pre-teen and teen years. It can oftentimes prevent the need for more complex treatment such as tooth extractions or jaw surgery and also makes the second phase of treatment easier resulting in shorter treatment time and reduced cost.  


Who Needs Two-Phase Treatment?

Not every child needs two-phase orthodontic treatment. If fact, at OAI we typically try to postpone orthodontic treatment until all of the permanent teeth are erupted in order to shorten overall treatment time and reduce cost for our patients as long as delaying treatment will not result in negative side effects such as irreversible enamel wear or asymmetric jaw growth. There are certain malocclusions, however, that need to be corrected early to prevent more complicated problems and costly procedures later on.  If left untreated, overcrowding and jaw discrepancies do not self-correct and will continue to worsen over time, sometimes becoming too severe for braces alone to be effective. Children with severe crowding and alignment problems or bite discrepancies such as crossbites or overbites can benefit substantially by an early phase of orthodontic treatment. This early intervention reduces the risk of impacted teeth (teeth getting stuck in bone), root resorption (shortening of the adult root) and gum recession, and additionally can prevent the need to have permanent teeth pulled or even jaw surgery!


What are the Benefits of Two Phase Treatment?

  • Improved oral health, function and aesthetics
  • Improved airways and speech
  • Reduced need for extractions (adult teeth pulled)
  • Reduced need for jaw surgery
  • Reduced risk of damage to the developing adult tooth root
  • Reduced risk of irreversible tooth enamel wear
  • Proper facial growth potential with an improved facial appearance
  • A nicer smile and improved confidence and self esteem

First Phase (Early Phase)

The first, or early phase of treatment, takes place during the early and mixed dentition phase. This means that the child still has primary (baby) teeth or more commonly a mixture of primary and permanent (adult) teeth. This treatment phase usually takes anywhere from 6-18 months and has specific treatment objectives such as correcting overcrowding and correcting functional and skeletal problems with the jaw to encourage symmetric jaw growth and a more balanced bite.  Early treatment may include an expander or functional appliance or a combination of appliances such as a headgear and braces.  Once the Phase I treatment objectives have been met, there is usually a resting phase or rest period while we are waiting for the remaining permanent teeth to erupt into the arch.  At OAI, we continue to monitor the growth and eruption on all of our Phase I patients during this time!  Sometimes early intervention can even prevent the need for a second phase of treatment!  


Second Phase

The second phase or comprehensive phase of orthodontic treatment begins once all of the permanent teeth have erupted. It typically involves a full set of upper and lower braces and an appliance to correct the bite. Every patient presents with a unique malocclusion and therefore has an individual treatment plan yet the goal of this comprehensive phase of treatment is the same: to achieve a perfect smile and functional bite for a lifetime!  Call our office to find out if your child may benefit from two-phase orthodontics!