TWO PHASE TREATMENT
TWO PHASE TREATMENT
WHAT IS PHASE I AND PHASE II TREATMENT?
Phase I orthodontic treatment is an interceptive and proactive treatment. It uses fixed or removable appliances for generally about 6-12 month period to correct poor jaw growth, create space for unerupted permanent teeth, break habits, and/or provide normal facial muscle and development before it is too late. The American Association of Orthodontists (AAO) recommends that a child’s first visit to an orthodontist should occur by no later than age 7. By that age, enough permanent teeth have emerged to evaluate relationships developing between the teeth, the jaw, and bite patterns to make sure everything in the mouth will continue to develop as it should. Early treatment may achieve results that are unattainable once the face and jaws have finished growing. Please see “Early Orthodontic Treatment” for more details.
* Usually at this age, patients will need extra help from their parents with brushing and flossing to stay motivated and maintain good oral hygiene.
After Phase I treatment is completed, all appliances are removed. Then your child will be observed about every 3-6 months until adolescent. A space maintainer or retainers may be provided during this observation period. Please note the teeth are not in their final position yet, and it is normal to see some relapse in the form of space opening between teeth and slight rotation or crowding, which all will be corrected in Phase Two.
Although approximately 10% of patients undergoing Phase I treatment will end up not needing Phase II treatment, 90% of Phase I patients will still eventually benefit from Phase II treatment utilizing full upper and lower braces or Invisalign to finalize the bite correction. Usually we are waiting for 12-16 more permanent teeth to erupt before Phase II begins. This most commonly occurs at the age of 12 or 13. By 12, most if not all of the permanent teeth have erupted and are in place, and crooked teeth, gaps and bad bites can easily be detected. Orthodontic problems don’t improve with age — they simply become harder to treat. It’s easier to treat many orthodontic problems during adolescence because the body is still growing rapidly at this time. In later years, when the bones of the face and jaws are fully developed, many conditions become more difficult (and costly) to treat.
The goal of Phase II Treatment is to position all the permanent teeth to maximize their appearance and function. This is best accomplished with full braces or Invisalign and is usually between 12-18 months long. Due to the improvements made in Phase I Treatment, Phase II Treatment requires less patient participation (no headgear and less rubber bands), often eliminates extraction of permanent teeth and reduces the time spent in full braces. Patients who have undergone both Phase I and Phase II treatments are more likely to have more stable results.
*We require our patients to take on more of the responsibility of their treatment themselves, especially when it comes to brushing, flossing and wearing rubber bands.
WHY TWO-PHASE TREATMENT?
Some patients have specific types of problems (like cross bites or severe crowding that prevents the normal eruption of teeth) that require orthodontic treatment at a younger age (around 7 to 9 years old). In these cases, it is beneficial to intervene with early orthodontic treatment because postponing the correction of these problems can create a more severe problem that is more difficult to correct later.
WHAT ARE THE BENEFITS OF TWO-PHASE TREATMENT?
Patients who receive two-phase treatment can achieve better results because some problems become increasingly difficult to correct as we get older and more teeth erupt.
Patients may require less dramatic intervention, in some cases avoiding the extraction of permanent teeth if space is managed effectively at a younger age.
Because both phases of treatment are kept shorter than one single phase, we find it easier to maintain motivation and compliance during the two phases.
Some types of problems, if not addressed early, can allow the permanent teeth to erupt into the wrong places or not erupt at all, which can even have an effect on the gums covering the teeth. Other problems can affect jaw growth. If these problems aren’t corrected early while the jaws are most receptive to growth modification, the patient’s only alternative later in life may be jaw surgery to correct the problem.