Two-Phase Treatment
Overview
At the beginning of the first phase, orthodontic records are 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 most adult teeth have erupted, and usually requires braces on all the teeth for generally 12-24 months. Retainers are worn after this phase to ensure you retain your beautiful smile.
What is the advantage of two-phase orthodontic treatment?
Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and physical, facial changes. Certain treatment options are only available at an early age when the teeth and jaws are developing. The major advantage of a two-phase treatment is using these options to maximize the esthetic, healthy, and functional result that will remain more stable throughout your life.
What are the benefits of early orthodontic treatment?
Early treatment presents the opportunity to:
- Keep a bad condition from becoming worse
- Direct developmental changes in desirable directions
- Influence jaw growth in a positive manner
- Preserve or gain space for erupting adult teeth
- Guide adult teeth into more favorable positions
- Improve position of first molar teeth
- Improve the width of the dental arches to allow eruption of all adult teeth and provide a better looking, fuller smile
- Reduce the need for extraction of adult teeth
- Reduce the likelihood of impacted adult teeth
- Increase the stability of the final result
- Lower the risk of trauma to protruding front teeth
- Improve lip competence
- Improve esthetics and self-esteem
- Correct harmful oral habits which affect growth and development, such as thumb habit, mouth breathing, tongue thrust
- Improve speech development
- Reduce potential for damage to TM joints by early correction of crossbites, tooth-grinding (bruxism), and lower jaw displacement
What if I put off treatment?
The important factor for your child is to have an early orthodontic evaluation to learn if the treatment options which are available only at an early developmental age are important to achieve the maximum result. Dr. White will discuss with you the appropriate timing for treatment, whether a two-phase treatment or placing your child on a recall schedule for a future evaluation for single phase treatment.
First Phase Treatment: Your foundation for a lifetime of beautiful teeth
The goal of first phase 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 and lower jaw that is growing too much or not enough can be recognized at an early age. If children age 7 or older are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Please see above: Advantages of early orthodontic treatment
Why age 7 is an ideal time for an orthodontic evaluation
- The posterior bite is established when the 6-year first molars erupt. (The space available for teeth around the arch from molar to molar does not change after the molars erupt.) The orthodontist can evaluate the front-to-back and width relationships of the bite, as well as any functional shift of the lower jaw.
- The presence of adult incisors indicate arch length, possible crowding, habit patterns, and vertical dimension problems such as deep bite, open bite, or gummy smile. Most facial asymmetries are likely to be apparent by age 7.
- For some, a timely screening will lead to significant treatment benefits; for others, early screening may indicate that treatment is not indicated, but the evaluation can provide information to relieve the parents concern that even though developing adult teeth may be temporarily unattractive, the developmental pattern may be normal.
Planning now can save your smile later
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. Thus, a good foundation can be established, providing adequate room for eruption of all 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.
Making diagnostic records to determine your unique treatment
Orthodontic records will be necessary to determine the best time and sequence of treatment, the type of appliances to be used, and the duration of treatment. The latest in digital technology is used which reduces the x-ray exposure to each patient and provides the most accurate records possible. Records consist of digital models of the teeth, digital x-rays of your teeth and jaws, and digital images of your teeth, smile, and profile. Dr. White uses information from each of these sources to determine the growth and development of your teeth, jaws, and face to plan treatment for you to give you the best looking smile possible.
Resting Period
In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices, usually worn only at night, are recommended to hold what was accomplished during the first phase, whether it be upper arch expansion or space created for adult tooth eruption.
Monitoring your teeth's progress
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 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 three to six-month basis.
Second Phase Treatment: Stay healthy and look attractive
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 Two records are taken to evaluate the amount and direction of growth that have occurred since the initial records. Dr. White will use information from all your records to plan for your treatment completion to give you the most stable, functional and healthy bite, and to create for you the best looking smile possible.
