The traditional thinking in orthodontics has been to wait to put on braces until after the permanent teeth have all come in. The thinking was that it was pointless to align the “baby teeth,” because they would just fall out anyway.
This type of approach has been challenged in recent years. Many orthodontists have begun using two-phase treatment, which begins in the late elementary school years, in order to achieve the best outcomes for their patients.
Phase I Treatment
The first phase of treatment begins in the late elementary school years. Braces are placed on the permanent teeth that have already erupted, and sometimes even on some of the baby teeth that haven’t fallen out yet. They are typically worn for about one year. The purpose of this treatment is to provide a healthy space into which the permanent teeth can erupt.
There are times when dentofacial orthopedics is needed during this Phase I treatment. This includes the use of appliances such as palatal expanders, to influence the growth of the jaw and facial bones to create the healthiest possible bite with plenty of space for all of the teeth.
Phase I treatment is also used to address certain habits, such as thumb-sucking and tongue-thrusting, that can have a long-term negative effect on dental and facial development. Addressing these habits early using orthodontics can give a growing child the chance to avoid more complicated orthodontic treatment in the future.
After Phase 1 treatment is complete, the early braces and/or appliances will be removed. A retainer is used to maintain the corrections, although if it begins to interfere with the eruption of the permanent teeth, it may need to be adjusted or discontinued. The patient then has a period of time without braces, while the remaining permanent teeth come in and as the patient grows. The patient needs to come in to see the orthodontist every few months to monitor progress and to adjust the retainer.
Besides allowing time for the permanent teeth to come in, this period without braces is also an opportunity for the patient to “rest” from orthodontic treatment. The child can experience the benefits of Phase I treatment, with a more attractive smile, while beginning the early adolescent years, a time when children often feel awkward about their appearance. This allows the child to see the results of early orthodontic treatment and to be ready for Phase II, if needed.
Phase 2 Treatment
When more of the permanent teeth are present, then Phase II treatment begins. This generally consists of a full set of braces, which can be metal braces, clear braces, or lingual braces. Invisalign may also be an option in certain cases.
Is Two-Phase Treatment Right for Your Child?
Certain types of orthodontic problems benefit from two-phase treatment, while other types of problems only require one full phase of treatment. To find out whether or not your child would benefit from two-phase treatment, you’ll need to bring your child to see an orthodontist you trust.
At Avenue Orthodontics, we offer a complimentary consultation and initial exam. This allows you to get all of the information that you need to make the best decisions for your child’s orthodontic care. We know that it can seem overwhelming to understand this information and to consider the many options available to you. We chose this profession in part because we absolutely love getting to meet new families, and supporting them as they make these important decisions.
At our Whitestone office, we serve patients from Douglaston, Little Neck, and the surrounding areas. We’d love to meet you and your family!