Two-Phase Treatment

A Special Kind of Orthodontic Treatment

First Phase Treatment

The goal of the first phase of 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 or 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.

Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. 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 jaw discrepancy too severe to achieve an ideal result with braces.

Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits. Records consist of models of the teeth, digital x-rays and digital photographs.

Resting Period

In this phase, the remaining permanent teeth are allowed to erupt. A successful first phase will have created room for all teeth to find and eruption path. Otherwise, thy may become impacted or severely displaced.

In other words, at the end of the first phase of treatment, teeth are not in their final position. This will be determined or accomplished in the second phase of treatment.

Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.

Second Phase Treatment

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. They will stay healthy and look attractive. This is the goal for the second and final phase of treatment.

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan established. Certain types of appliances were used in the first phase, as dictated by the problem. The second phase is initiated when all or most permanent teeth have erupted and usually requires braces on all teeth. Retainers are worn after this phase.

Advantages of Two-Phase Treatment

Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and facial changes. The emphasis today on living longer, staying healthy, and looking attractive requires optimum treatment results. The major advantages of a two-phase treatment are: (1) To maximize the opportunity to accomplish the ideal healthy, functional, aesthetic result that will remain stable and (2) To shorten treatment time in full braces.

The disadvantages of waiting for complete eruption of permanent teeth and having only one phase of treatment for someone with a jaw discrepancy are: (1) Having to face the possibility of a compromised result that may not be completely, functionally healthy, (2) Results that may not remain stable, and (3) The need to wear braces for a longer period of time.