Two-Phase Treatment

What is two-phase orthodontic treatment?

Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and facial changes. The major advantage of a two-phase treatment is to address tooth and jaw problems early in order to prevent future problems in tooth and jaw development. Later, a second phase of comprehensive orthodontic treatment is often indicated to perfect final tooth positions when all of the permanent teeth are present.

Why two phases instead of one?

Two-phase orthodontic treatment is not needed in all cases. Sometimes, as growth begins, the teeth and jaws don’t start in the right position. An early, first phase of orthodontic treatment can correct poor alignment if it is deemed to be more severe. After the teeth and jaws are in a better position, dental and facial development can continue more favorably. The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment—when two-phase treatment is indicated—is the potential for missing out on a crucial period of tooth and jaw development when specific movements can be done more easily and are more stable.

Planning now for your future smile

First Phase Treatment: Your foundation for a lifetime of beautiful teeth

Because children grow rapidly, they can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. The goal of first phase treatment is to develop the jaw size in order to accommodate all of the permanent teeth and to relate the upper and lower jaws to each other. 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 may be candidates for early orthodontic treatment. This early correction may prevent later removal of permanent teeth to correct overcrowding and/or surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with braces.

Resting period after the first phase
In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices may be worn during this time. A successful first phase treatment allows the teeth and jaws to maintain a healthy relationship during this crucial period of growth.

Monitoring your teeth's progress
At the end of the first phase of treatment, all of the teeth may not be in their final positions. This will be closely monitored and perfected later in the second phase of treatment. Selective removal of certain primary (baby) teeth during this resting phase may be in the best interest of enhancing the position of the permanent teeth. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.

Second Phase Treatment: Stay healthy and look attractive

The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, your teeth will look great and function properly! The second phase is initiated when all permanent teeth are ready for eruption and usually requires braces on all the teeth for an average of 24 months. Because the teeth and jaws are in better position after the first phase, we can concentrate on making a beautiful smile in the second phase more efficiently. Retainers are worn after this phase to ensure you retain your beautiful smile for life.