Two-phase orthodontic treatment for children

All things baby teeth

Children begin to lose their 20 baby teeth starting around the age of six. During this time, 28 adult teeth will gradually take their place over the next six or so years. As these larger and more numerous adult teeth erupt, orthodontic issues, like crowding, a poor bite, or misalignment, can begin to develop.

While many people may think that you need to wait for adult teeth before beginning orthodontics, this is not the case. Although teen and adult braces are very effective, orthodontists can intervene far earlier with something called two-phase treatment.

What is two-phase treatment?

There is no cookie-cutter age for orthodontic care. However, we recommend that kids visit around the time that permanent teeth first begin to come in—typically this is at seven years old. At this point, our orthodontists can detect issues early, like crowding and misalignment, and create a two-phase treatment plan if it is beneficial.

Two-phase treatment can minimize the likelihood that your child will require surgery or extractions later on. By working with your child’s natural facial growth, we can often treat problems early—before they become more serious. For instance, two-phase treatment allows us to address issues like crowding. If we notice the signs of a narrow dental arch, we might use appliances, like a palate expander. This device guides a child’s growth to create space for teeth as they erupt. A wider arch then becomes the foundation for a healthy smile transformation during the second phase of treatment.

What if orthodontic treatment is put off?

Putting off orthodontic treatment can result in a need for more invasive treatment later in life that may not completely fix your child’s smile. Early treatment is most effective for achieving lasting results.

What conditions can be treated with two-phase orthodontic treatment?

There are many problems that might require this form of treatment. Examples include:

  • Thumb-sucking past the age of three
  • An abnormally narrow palate
  • Jaw abnormalities
  • Missing teeth
  • Premature loss of baby teeth
  • Crowding
  • Open bites
  • Crossbites

What is an open bite?

An open bite is an abnormality in which the front teeth don’t meet when the mouth is closed. It can be caused by jaw abnormalities or bad habits like prolonged thumb-sucking or tongue-thrusting. If an open bite isn’t corrected, it can lead to problems with chewing and premature wear on the back teeth. It has also been linked to temporomandibular jaw (TMJ) disorders.

In some cases, the open bite will go away on its own. This is especially likely to happen if the child has an open bite simply because they have a mix of baby and adult teeth. In most cases, the child will need two-phase orthodontic treatment. They will need help breaking bad habits, or they will need to have their jaw worked on. In the latter case, the orthodontist may recommend one of several appliances to guide their jaw growth and bring their teeth into a normal position during the first phase.

The two-phase treatment process

Phase one

The goal of Phase One treatment is to help the jaw develop in a way that will accommodate all of the permanent teeth and improve the way the upper and lower jaws fit together. Children often exhibit early signs of jaw problems as they grow and develop. An upper jaw that is growing too much or is too narrow can be recognized at an early age. If children over the age of six are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Also, if children around the age of eight have crowded front teeth, early treatment can prevent the need to extract permanent teeth later.

Planning now can save your child’s smile later. Children 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 treatment. Orthodontic 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, the doctor 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 progress. At 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

The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly. Phase Two usually involves full upper and lower braces.

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was established. Certain types of appliances were used in the first phase to correct and realign the teeth and jaw. The second phase begins when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure your child retains his or her beautiful smile.

Getting the best treatment for your child

As a parent, you want your child to have the best quality of life possible. Having a healthy set of teeth and a healthy jaw is a big part of this. Schedule an appointment at Petty & Bielik Orthodontics in Oak Lawn to see if two-phase orthodontic treatment is right for your child. Contact us today to book a free consultation.