Two Phase Orthodontic Treatment

Why are kids wearing braces at so young of an age and does everyone have to start orthodontic treatment early in life? Children sometimes exhibit early signs of jaw problems as they grow and develop. These problems include an upper or lower jaw that is growing too much, not growing enough, or there is not enough room for all the teeth to erupt. Two phase orthodontics is a special approach to treating these problems. And, no, every child does not need to wear braces early; it is for special circumstances as described below.

First Phase Treatment

The goal of 1st phase orthodontic treatment is to develop the jaws in order to accommodate all the permanent teeth and to properly relate the upper and lower jaws to each other. Because children are growing rapidly, they can benefit enormously from an early phase of orthodontic treatment utilizing appliances to direct the growth relationship of the upper jaw to the lower jaw. Thus, a good foundation can be established providing adequate room for the eruption of the permanent teeth. 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.

Orthodontic records will be necessary to determine the type of appliances to be used, the length of treatment, and as baseline information since the shape of the jaws will be altered. Records consist of models of the teeth, x-rays, and photographs.

Resting Period

The permanent teeth are allowed to erupt in between the 1st and 2nd phases. Retainers are worn to maintain the result of the 1st phase until interferences with eruption of the remaining teeth is observed. A successful 1st phase will have created room for the permanent teeth to find a favorable eruption path. Otherwise, impaction or severe displacements of teeth are possible. Remember that at the end of the 1st phase the permanent teeth are not in their final positions. This is because there are usually up to 16 permanent teeth that have yet to erupt that we have no control over. Thus, the final positions of the teeth will be determined and accomplished in the 2nd phase of treatment. It is important to continue observation of the erupting teeth and the frequency of appointments varies from person to person.

Second Phase Treatment

The goal of the 2nd phase of orthodontic treatment is to place the teeth into equilibrium such that they will function together properly, be healthy, and look attractive. Each tooth has a location within the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. As was the case in the 1st phase, orthodontic records are necessary to establish the appropriate diagnosis and treatment plan. This 2nd phase is usually initiated once all the permanent teeth have erupted and usually requires braces on all the teeth for a period of time ranging from 12-18 months.

Two phase orthodontics involves changing jaw structure and jaw relationship to create a more favorable environment for the eruption of a full permanent dentition. Potential advantages to this approach are a reduction of the overbite or underbite, allowing for more normal future jaw development, and the possibility that future treatment may not be needed.