Two-Phase Treatment

Lisa D. Howard DDS, MS Scarborough-Two Phase TreatmentWhat is two-phase orthodontic treatment?

Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and facial changes. The major goal of a two-phase treatment is to address tooth and jaw problems early on in the first phase to prevent future problems and maximize future tooth and jaw development. Later, a second phase of orthodontic treatment is often indicated to perfect final tooth positions when all of the permanent teeth are present.

Why two phases instead of one?

Two-phase orthodontic treatment is not needed in all cases. Sometimes, as growth begins, the teeth and jaws don’t start in the right position. An early, first phase of orthodontic treatment can correct poor alignment if it is deemed to be more severe. After the teeth and jaws are in a better position, the rest of dental and facial development can continue more favorably. The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment, when two-phase treatment is indicated by your orthodontist, is the potential for missing out on a crucial period of tooth and jaw development.

Planning now for your future smile

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. A proper foundation can be established, providing adequate room for the eruption of all permanent teeth. An upper and lower jaw that is growing too much or not enough can be recognized at an early age. 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.

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. Once the tooth and jaw positions are improved, we take a break and let growth continue.

Resting period after the first phase

In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices may be worn for a short period during this stage but as the permanent teeth erupt the retainer then may no longer fit and be discontinued by Dr. Howard. Successful first phase treatment allows the teeth and jaws to maintain a healthy relationship during this crucial period of growth.

Monitoring your teeth’s progress

At the end of the first phase of treatment, all of the teeth may not be in their final positions. This will be closely monitored and perfected later in the second phase of treatment. Selective removal of certain primary (baby) teeth during this resting phase may be in the best interest of enhancing the position of the permanent teeth. Therefore, periodic recall appointments for observation of growth and development are necessary, usually on a six-month basis.

Second Phase Treatment: Stay healthy and look attractive

The second phase is initiated when all permanent teeth are ready for eruption. The goal of the second phase is to make sure each tooth has an exact location in the mouth where it looks and fits the best. Because the teeth and jaws are in better position after the first phase, we can concentrate on making a beautiful smile in the second phase. Retainers are worn indefinitely after this phase to ensure you retain your beautiful smile for life. For approximately the first six months following the band removal, the retainers should be worn 24/7, except for eating and brushing. After that they can be worn at night only, unless Dr. Howard advises you differently.