Two-Phase Treatment

Not every child will need two distinct orthodontic phases of treatment. As a matter of fact studies have shown that there is no differene between results achieved treating children in two phases versus one phase, providing that no intervention is needed early.   The American Association of Orthodontists recomends that every child should have an orthodontic consultation by age 7. We can tell if they are crowded or spaced, if dental development is normal or delayed, if growth is normal or potential bite problems are developing. Orthodontists are specialists trained to look for abnormal patterns such has underbites, overbites with risk of trauma, crossbites and asymmetries. In addition, we evaluate swalowing, breathing patterns, harmful habits and try to look in the future.  Scanning the whole dentition with a digital low dose panoramic radiograph will provide tremendous information regarding unerupted teeth. And sometimes we see surprizes such as pathology, cysts, extra teeth or congenitally missing teeth or impactions.  We educate the parents, propose treatment options such as expanders, partial braces, sometimes habit correctors or baby teeth extractions in combination with fixed or removable appliances and whatever else is deemed necessary to help that particular child.

What if treatment is put off?

Putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your son or daughter’s smile. Early treatment is most effective for achieving lasting results and preventing more serioous complications. Some parents resist having xrays taken, or having primary teeth extracted, or pospone creating space until later. The problems will not disappear, usually they become worse. Impacted teeth can take a wrong turn and chew or resorb or disolve the roots of some adult neighbouring teeth, to the point that some may become severely compromised and lost in the future.  Like everything else in medicine, It is a lot easier and a lot less expensive to do prevention than dealing with the aftermath of not starting treatment at the right time.

Phase One

A Foundation for a Lifetime of Beautiful Smiles

The goal of Phase-One treatment is to help create a more balanced arch development or environment for the incoming permanent teeth to erupt, wether is is about using expanders or partial braces in one or both jaws, or break bad habits.  As mentioned many children often exhibit early signs of jaw problems as they grow and develp, well before they are ready for a full set of permanent braces.

In my own family, two of my children needed phase I. One with an expander and partial upper braces to relieve crowding,  the other one due to growing into an underbite, needed a bonded expander with face mask hooks for a reverse pull headgear or facemask. All of them completed phase I in less than a year and required full braces/aligners once the remaining permanent teeth erupted.

Needless to say, for various timing and sometimes financial and insurance considerations, some patients will present for treatment much later in life, and we hear ouerselves saying: " I wish I would have met you earlier in life, so I could have expanded you before being done growing and prevent extractions,  surgery, or impactions"...

• Planning now can save your child’s smile laterChildren benefit tremendously from early-phase treatment. Receiving early treatment may prevent the removal of permanent teeth later in life, or the need for surgical procedures to realign the jaws.
• Making records to determine your child’s unique treatmentOrthodontic 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, we will take records to determine if early treatment is necessary.

Resting Period

In this phase, the remaining permanent teeth are left alone as they erupt. Retaining devices may not be recommended if they would interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement.

A successful first phase will have created room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.

• Monitoring the teeth’s progressAt 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 six-month basis.

Phase Two

Stay healthy and look attractive

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was formulated and hopefully executed.  Certain types of appliances were used in the first phase to correct and realign the teeth and jaw.

Now that all permanent teeth are available, new records and goals are desired. Most likely, if is about fine tuning individual teeth position, having a good bite and achieveing a beautiful healthy smile.   Weather this is done with a traditional set of full metal or clear braces, or clear Invisalign or SureSmile aligners, it is up to the patient and parents to select the most appropriate choice of treatment. In some cases, having had a Phase I orthodontic treatment may reduce the overall length of phase II comprehensive orthodontics.  Retainers, wether fixed or removable or a combination, will need to be worn after this phase to ensure your youngster retains his or her beautiful smile for years to come.