PHASE I TREATMENT

As children grow and develop, they may exhibit early signs of jaw problems. For instance, too much or too little jaw growth results in an incorrect jaw relationship, which in turn affects the profile and bite. Improper jaw growth can also result in incorrect function. In many instances, crowding of the teeth will be evident at a young age (even before all the baby teeth are lost), and this affects proper permanent tooth eruption.

The goal of Phase I is to "level the playing field," so that Nature is given the best chance at developing a smile that is both functionally correct and cosmetically pleasing. Because children grow so rapidly, they can greatly benefit from Phase I appliances that are able to affect the relationship between the upper and lower jaws as well as tooth relationships. Hence, the first phase may involve orthopedic (jaw-related) correction as well as orthodontic (tooth-related) movement. Completion of Phase I may eliminate the need for removal of permanent teeth and/or the need for jaw surgery in the future. Waiting for all of baby teeth to be lost can result in a tooth/jaw discrepancy that is too severe to be resolved by braces alone.

Observation ("Resting") Period

During this time, the last of the baby teeth will be lost and the remaining permanent teeth will erupt. A successful first phase will have increased space for the permanent teeth, often preventing SEVERELY crowded or IMPACTED teeth. Periodic visits are scheduled in order to monitor growth and development. At times, selective removal of baby teeth may be necessary in order to guide or enhance the eruption of the permanent teeth. Limited use of passive appliances is common during this time in order to maintain the results of Phase I treatment (retainer or space maintainer).

The nature of treatment in this "full braces" phase is more tooth-related than jaw-related. The goal is to achieve a pleasant smile and a bite in which the teeth function properly, not only with each other, but with the lips, tongue, and cheeks as well.

Orthodontic records are again taken prior to beginning Phase II in order to evaluate the patient's current status following growth and development ("puberty"). The second phase may involve wearing full braces anywhere between 9 to 24 months, depending on the complexity of the case and the compliance of the patient. After treatment is completed, the braces are removed and custom retainers are fabricated and worn as prescribed (indefinitely).

Advantage to Two-Phase Treatment

Two-phase orthodontics is a specialized process that involves both tooth straightening and physical changes in facial bones and soft tissues. Due to previous improvement in jaw size and relationship, less actual tooth movement is usually required in Phase II. Often, in this phase, the "detailing" work is accomplished.

You may be wondering, "What is the problem with waiting until all the permanent teeth come in before starting treatment?" The answer is that waiting until this time has allowed the full expression of the problem(s) and now leaves only one chance to correct it. For instance, in the case of a jaw discrepancy, there is now the possibility of needing braces and jaw surgery in order to correct it. In addition, removal of permanent teeth may now be unavoidable, and attractive facial aesthetics (profile) therefore compromised. The emphasis today on living longer, staying healthy, and looking attractive requires optimum treatment skills. Two-phase orthodontics maximizes the opportunity to achieve a healthy and aesthetic smile.