Two-phase orthodontic treatment is a specialized process combining tooth straightening and physical, facial changes. The purpose of two-phase treatment is to maximize the opportunity to achieve a healthy, functional and aesthetic result that will remain stable throughout your life. Phase I treatment will often create space to avoid extractions, correct skeletal problems to avoid surgery in the future, and is done to provide a better overall outcome and a more stable result.
Putting off treatment can result in the need for more invasive treatment later that may not completely fix a smile. Early treatment is often the most effective way to achieve lasting results.
The goal of Phase I treatment is to help the jaw develop in a way that will accommodate all the permanent teeth and improve the way the upper and lower jaws fit together. Children often exhibit early signs of jaw problems as they grow and develop. An upper jaw that is growing too much or is too narrow can be recognized at an early age. If children over the age of six are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Also, if children around the age of eight have crowded front teeth, early treatment can prevent the need to extract permanent teeth later. 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, X-rays, and photographs. During your child’s initial consultation, your doctor will take records to determine if early treatment is recommended.
In this phase, the remaining permanent teeth are left alone as they erupt. Retaining devices may not be used if they will interfere with eruption. It is good to allow the existing permanent teeth some freedom of movement. A successful first phase will create room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced. At the end of the first phase of treatment, teeth are not in their final positions. This will be accomplished in the second phase of treatment. Selective removal of certain primary teeth may improve eruption for permanent teeth during this resting phase. Therefore, periodic recall appointments for observation are necessary.
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. Phase II usually involves full upper and lower braces. The second phase typically begins when all permanent teeth have erupted. Retainers are worn after this phase to preserve the results for life.