Early Orthodontics

Two-Phase Treatment

Two-Phase Orthodontic Treatment is a very specialized, proactive process that encompasses jaw changes, facial changes, and tooth straightening. The major advantage of Two-Phase Treatment is to maximize the opportunity to accomplish the ideal healthy, functional, esthetic, and comfortable result that will remain stable. In some cases, completing orthodontic treatment in two phases prevents adult tooth extractions or major jaw surgery.

When undergoing two phases of orthodontic treatment, the first phase mainly addresses the jaws with self-activating expanders, while the second phase straightens the teeth and corrects the bite using Pitts21 braces or Invisalign. The first phase is a critical set-up for the second phase.

The first phase of orthodontic treatment is one of the most rewarding treatment options that we offer to our patients, as it is proactive treatment. The idea of the first phase is to positively guide growth, create space for unerupted teeth, break habits, and prevent trauma before it is too late. Using children’s growth potential in a positive way while they are still very young is key. Jaws being the correct size and shape sets a positive foundation for permanent teeth to come into place much better. The first phase also contributes to facial growth proceeding in a positive way. Positive tooth eruption and ideal jaw development can help patients to avoid many negative side-effects later. Including:

  • Asymmetric/crooked facial growth
  • Gingival/gum defects requiring surgery
  • Avoidable extractions of permanent teeth
  • Impacted or ankylosed teeth (stuck in the bone)
  • Major jaw surgery

The first phase is completed on children between the ages of 7 and 10. Young children are flexible and compliant, and their growth potential is still at a maximum. Treatment usually lasts 6 to 12 months, after which, retainers are placed to hold the new position for 10 months. Once the jaws have settled in their new positions, the retainers are removed, and patients are regularly monitored until they are ready to move into the second phase.

Most children will require a second, more comprehensive phase of treatment in order to create a superbly fantastic smile with a stable, healthy bite. The second phase of treatment begins once most of the adult teeth have erupted (i.e. grown in). This second phase is typically much simpler and shorter than a full case on a patient who has not gone through the first phase, and the results of Two-Phase Treatment are significantly better than those on patients who needed a first phase, but waited for all of the adult teeth to come in instead, as too much time and growth potential have been lost by then. Those patients who need both phases and undergo both phases have outstanding results! After the second phase of treatment, retainers will worn daily 10 to 12 hours in order to hold the teeth in correct position.

At What Age Should A Child First Visit the Orthodontist?

Dr. Cheryl L. Held follows the American Association of Orthodontists (AAO) guidelines. The AAO recommends that all children be seen for the first time by age 7, or earlier if a problem is detected by the parents, primary care dentist (PCD), or pediatrician. This initial evaluation allows Dr. Held to determine when orthopedic or orthodontic treatment will be required and the best time for each patient to be treated. 

Here’s Why:

Orthodontists can detect subtle problems with jaw growth and emerging teeth while baby teeth are still present. While your child’s teeth may appear to be straight, there could be a problem that only an orthodontist can detect.

An initial evaluation may reveal that your child’s teeth and bite are fine. Or, it may allow Dr. Held to determine that early treatment is indicated to prevent more serious problems from developing. Alternatively, Dr. Held may identify a developing problem to watch for, but recommend monitoring your child’s growth and development and to begin treatment at an older age.

Early treatment may prevent more serious problems from developing and may make treatment at a later age shorter and less complicated. In some cases, Dr. Held will be able to achieve results that may not be possible if treatment is begun at a later age, after losing time and growth potential of the jaws and face.

Problems to Watch for in Growing Children

  • Early or late loss of baby teeth
  • Crossbite
  • Open Bite
  • Difficulty in chewing or biting
  • Mouth breathing
  • Jaws that shift or make sounds
  • Speech difficulties
  • Biting the cheek or the roof of the mouth
  • Grinding or cleaning or the teeth

If Indicated, Early Treatment Will Give Dr. Held the Opportunity to:

  • Guide jaw growth
  • Lower the risk of trauma to protruded front teeth
  • Correct harmful oral habits
  • Improve appearance
  • Guide permanent teeth into a more favorable position
  • Create a more pleasing arrangement of teeth, lips, and face

Through an early orthodontic evaluation, you will be giving your child the best opportunity for a beautiful, healthy smile for life.

If your child is older than age 7, it’s certainly not too late for an evaluation.

Because patients differ in both physiological development and treatment needs, Dr. Held’s goal is to provide each patient with the most appropriate treatment at the most appropriate time.

Does Early Treatment Benefit All Children?

Early treatment does not necessarily benefit all children. Certain types of orthodontic problems can be more easily and efficiently corrected in the teen years when all the permanent teeth have erupted. Some skeletal orthodontic problems should not be addressed until growth is more advanced or completed.

Dr. Held will develop a plan for treatment based upon your child’s individual needs. If Dr. Held determines that your child is not ready for treatment, he or she will become a member of our Orthodontic Kids Club, and a complimentary observation schedule will be arranged until he or she is ready to begin treatment. For the best results over a lifetime, it is essential that your child has an orthodontic evaluation by age 7.

What is Your Orthodontic Kids Club?

Our Orthodontic Kids Club is for patients who are not yet ready for treatment. This program enables Dr. Held to monitor periodically the eruptive pattern of your child’s permanent teeth as well as his or her facial development. Dr. Held normally monitors patients in our Orthodontic Kids Club every 6 months to observe their progress as they grow. There is no fee for this program, and it is critical to help Dr. Held to determine the optimum time to begin treatment and to achieve the best possible results.

In Addition to a Beautiful New Smile, What Are Some Other Benefits of Orthopedic and Orthodontic Treatment?

Orthopedic and orthodontic treatment can improve the function of the bite and teeth, improve the ability to clean the teeth, prevent wear on the teeth, and increase the longevity of natural teeth over a lifetime.

If A Child Has Treatment Early, Will this Prevent the Need for Braces as an Adolescent?

Early (Phase I) treatment can begin the correction of significant problems, prevent more severe problems from developing, and simplify future treatment. Because all of the permanent teeth have not yet erupted when early treatment is performed, their final initial position may not be ideal. Typically, a second comprehensive phase of treatment (Phase II with the Pitts21 Braces System or Invisalign) in the teen years, after all of the permanent teeth have erupted, completes the orthodontic correction. However, in rare circumstances, further orthodontic treatment may not be indicated after Phase I treatment.

Do We Still Need to See Our PCD During Orthopedic and/or Orthodontic Treatment?

Patients with expanders, braces, and other orthodontic appliances require more effort to keep their teeth and gums clean. Because we want to insure the highest level of dental health, we recommend that your child sees his or her PCD for regular check-ups and cleanings every 6 months during treatment, or more if the PCD recommends it.