What is two-phase treatment?

Two phase treatment consists of Phase 1 orthodontics for a period of about 1 year followed by Phase 2 orthodontics when all the adult teeth have grown in.  Phase I is started around ages 7-9 and takes place while baby teeth are still in the mouth.  There are different reasons to start phase 1.  The most common are crowding, underbite, overbite, and cross bite.  After phase 1 is complete, temporary retainers are provided to hold things in place until all adult teeth have grown in.  Then phase 2 begins, and this involves full braces or Invisalign.

What is the advantage of two-phase orthodontic treatment?

The major advantage of a two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, and esthetic result that will remain stable throughout your life.  This may also equate to avoiding extraction of permanent teeth or avoiding future jaw surgery to correct the bite.

Does every patient need two-phase treatment?

The simple answer is no.  The American Association of Orthodontists recommends all children have the first orthodontic exam at age 7.  If there is plenty of room for all of the permanent teeth to erupt and no bite problems then phase 1 is not needed.  Only an orthodontist can determine if two-phase is needed or not.

Phase 1 Treatment: What happens in phase 1?

The goal of first phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment.  An example of a phase 1 treatment would be an expander to widen the upper jaw followed by braces on the 4 front teeth to align them.

Resting Period

In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices are not usually needed for the full duration of the rest period since they may interfere with eruption.  A removable upper retainer and a lower cemented wire are typically used for several months.  Dr. Chenard will check the retainers as needed to determine the length of use.  A successful first phase will have created room for teeth to find an eruption path.

Phase 2 Treatment:  What happens next?

The goal of the second phase is to position each tooth’s location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly.

The second phase is initiated when all permanent teeth have erupted, and usually requires braces or Invisalign for an average of 18-24 months. Retainers are worn after this phase to ensure you retain your beautiful smile!