2 Phase Ortho Treatment

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You might have noticed many younger patients with braces on both permanent and baby teeth. However, not every patient benefits from early interceptive treatment or two-phase treatment instead of the traditional orthodontic approach.

Orthodontic treatment isn’t a “one size fits all” approach. Each patient has unique needs, requiring a tailored treatment plan for optimal results. That’s why the American Association of Orthodontists recommends an orthodontic evaluation by age 7 or at the first sign of an orthodontic problem.

By age 7, most children have enough permanent teeth to determine whether an orthodontic issue exists or is developing. Ideally, we’d evaluate them when their permanent teeth start to emerge. At this stage of dental development, children usually fall into one of three categories:

  • Category 1 – Teeth and jaws are developing normally, but tooth alignment may not be perfect. We may recommend periodic observation until the rest of the permanent teeth erupt. Later, traditional comprehensive orthodontic treatment will be offered.

  • Category 2 – Teeth have mild to moderate esthetic issues, but jaws are usually developing normally. Children in this category may have spacing or rotated teeth causing self-consciousness or social anxiety. They could wait for traditional orthodontic treatment, but two-phase treatment may be offered as an option for early correction. A second phase after the permanent teeth have erupted is required for a comprehensive result.

  • Category 3 – Teeth or jaws have moderate to severe problems. In these cases, we may recommend early interceptive treatment or two-phase treatment. If there’s a real benefit in early treatment, we’ll recommend it. Usually, after an early phase one treatment, a second phase or full treatment is required to straighten all the teeth after the permanent teeth have erupted.

What is the advantage of two-phase orthodontic treatment?

A small number of cases benefit from two-phase orthodontic treatment. However, some orthodontists recommend it for nearly every patient. It’s important to know that two-phase treatment typically costs more than one-phase treatment. If you’ve been told your child needs early or two-phase treatment, consider getting a second opinion.

Phase – One

This treatment focuses on specific goals and objectives since only some permanent teeth are present. Phase one treatment is customized for each patient’s early needs. It is typically completed within 12 months.

It is not uncommon to see different phase-one treatment for members of even the same family. Rest assured, Dr. Cook and Dr. Talbot thoroughly evaluate each patient to determine which phase-one strategy will help your child achieve the best possible phase-one result.

Resting Period

At the end of phase one, teeth aren’t in their final positions. During the resting period, we wait for the remaining permanent teeth to erupt. Retainers are usually recommended, but they often only cover select teeth. Periodic recall appointments for observation are necessary, usually on a six-month basis.

Phase – Two

The second phase begins when all permanent teeth have erupted, around ages 12-13. The goals of this phase are more comprehensive, ensuring each tooth is in the ideal location and the upper and lower jaws are in good balance. Phase two usually involves full upper and lower braces on all permanent teeth or Invisalign Teen. Afterward, retainers are worn to maintain the achieved smile.

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