Two-Phase Treatment">

two-phase treatment

When is two-phase orthodontic treatment recommended?

There are only a few cases when early (phase I, age 6-10) orthodontic treatment is recommended. They are:

  • An anterior crossbite (1 or more of the upper front teeth are behind the lower front teeth upon biting.)
  • A posterior crossbite that causes a shift of the jaw upon closure.
  • Premature loss of a baby tooth that may allow shifting of the adjacent permanent teeth.
  • Moderate to severe lower crowding with or without the tendency for excessive lower jaw growth.
  • Growth modification (when there is more lower jaw growth than upper jaw growth)

What if I put off treatment?

There may be several disadvantages of waiting for complete eruption of permanent teeth and having only one phase of treatment. They are:

  • Possible gum loss or visible enamel wear and notching of the teeth.
  • Asymmetric jaw growth.
  • Impaction of a permanent tooth or asymmetric eruption and tooth alignment.
  • Extractions may be necessary or only a compromised orthodontic result may be achievable.
  • Extractions or orthognathic surgery may be required to obtain a proper occlusion.

Resting/Recall Period

In this phase, the remaining permanent teeth are allowed to erupt. Retainers are usually worn for 3-6 months but are then discontinued to allow the loss of the baby teeth and eruption of the permanent teeth. It is best to allow the existing permanent teeth some freedom to move while final eruption of the rest of the teeth is occurring. In other words, at the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain baby teeth may be beneficial for the proper eruption and alignment of the rest of the teeth, so periodic recall appointments to monitor growth and eruption are necessary, usually on a 6-12 month basis.

Second Phase of Treatment

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, the teeth will function together properly.

Back to Top