One vs. Two Phase Orthodontic Treatment

What is the purpose of a Two Phase Treatment?

The American Association of Orthodontists recommends that an orthodontist screen all children for orthodontic problems by the age of 7 years old. Here at Drake Orthodontics we support this recommendation being fully aware that some orthodontic problems are best treated in two phases. In fact, amazing results can be achieved with two-phases of treatment when it’s done at the appropriate time and when necessary.

However, most children do not need two-phase treatment and here at Drake Orthodontic we will let you know that a lot of recent orthodontic clinical research has demonstrated that some of the early orthodontic problems, even though they appear quite severe and disturbing to parents, are best treated in a single stage of treatment later, around the age of 11-13 when all permanent teeth are in, rather than in two phases of treatment.

Unfortunately, some orthodontists and general dentists aggressively treat many children with an unnecessary first phase of treatment. This results in treatment that is no more effective or efficient – with far more appointments over time, with far greater cost to the family, and with no better end result for the child than what would have been achieved with an appropriate and well-timed single phase of treatment. Both Dr. David Drake and Dr. Ethan Drake believe in this philosophy of giving you the most efficient treatment at the most appropriate time which means that sometimes a first phase of treatment is necessary and sometimes its not.

When you bring your child into Drake Orthodontics for a consultation we will honestly tell you which types of orthodontic problems should be treated in two phases, and which problems can and should be delayed until all of the permanent teeth have come in and which problems should be treated with an early or interceptive stage of treatment. Statistically in our practice, we recommend two phases of treatment for our younger patients less than 20% of the time.

Phase I Treatment

Phase I, or early interceptive treatment, is a limited orthodontic treatment (i.e., expanders, growth appliances, or partial/limited braces) before all of the permanent teeth have erupted. Such treatment can occur between the ages of 7 and 11 and usually lasts 10 to 14 months long. This treatment is often recommended to make more space for developing teeth when early signs of severe crowding are present, and to correct crossbites (reverse bite relationships), severe overbites and underbites, premature loss of “baby” teeth, tooth eruption abnormalities, or harmful oral habits. Any problem where dental arches need to be developed, jaws need to be widened, and/or jaw growth needs to be “stimulated”, or modified, would be started before all permanent teeth are in. Phase I treatment creates a good foundation for the erupting permanent teeth, and corrects growth/jaw problems that would otherwise require permanent tooth extractions, complex/extensive orthodontic treatment, and/or jaw surgery later.

At the end of the first phase of treatment, teeth are not in their final, ideal positions, which will be determined and accomplished in the second phase (Phase II) of treatment.

Resting Period

During this resting period, the remaining permanent teeth are allowed to erupt and patient growth is allowed to occur. Retainers are usually recommended, at least initially, but may be discontinued if they begin to interfere with the eruption of the permanent teeth into the arch.

Phase II

Phase II treatment involves full braces when all of the permanent teeth (usually including the 12-year molars) have erupted, usually between the ages of 11 and 13. Phase II is usually the final stage of multi-phase treatment and on average requires 18-30 months of treatment. During Phase II treatment, the permanent teeth are moved into ideal place to create optimal esthetics and function leaving you with a big, beautiful, straight smile, which contributes, to an healthy bite. It is during this second phase (Phase II) that your new, beautiful smile comes together.

One Phase Treatment

One phase treatment involves full braces when all of the permanent teeth (usually including the 12-year molars) have erupted. This also occurs between the ages of 11 and 13 and again lasts on average from 18 to 30 months. This type of orthodontic treatment only has this one stage of treatment and during treatment all the permanent teeth are moved into ideal position to create optimal esthetics and function leaving you with a big, beautiful, straight smile, contributing to a healthy bite.