All About Two-Phase Orthodontic Treatment

Two-phase orthodontic treatment at Icon Orthodontics is a specialized process that combines tooth straightening and physical, facial changes. The purpose of two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, and aesthetic result that will remain stable throughout your child's life.


Reasons for Two-Phase Treatment

Typically about one in three children between ages 7-10 will require two-phase treatment for specific reasons including, but not limited to the reasons below.


A crossbite refers to a condition where the top teeth are "stuck" behind the bottom teeth. This can lead to an uncomfortable bite and asymmetry of the face and chin as the child tries to shift their lower jaw to fit with the crossbite tooth or teeth.

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Impacted Teeth

Impacted teeth are those that get "stuck" underneath the bones and gums on their way into the mouth. These are usually permanent teeth and are often not noticed without taking an X-Ray that Dr. Sarpo or Dr. Sun will read.

Treatment for such conditions can be simple if caught early or may require surgery if left unnoticed until later in life.

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Thumb Sucking or Other Oral Habits

Thumb sucking is mostly harmless in the early stages of life, however, such habits can have serious effects on the developing teeth and mouth if left to persist. Problems that can arise include narrowing of the upper jaw and separation of the front teeth (called open bite) to name a few.

Early intervention can include positive reinforcement, socks or hot sauce placed on the hands, or placement of appliances in the mouth to physically obstruct the thumb from entering. Like all habits, cooperation and desire to change are necessary from the child for a successful outcome.

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Poor Self Esteem

It is important not to overlook the value of treatment for children who suffer from bullying or poor self-esteem as a result of the appearance of their teeth.

Although aesthetics is often not a primary concern during the first phase of treatment, it is important to let Dr. Sarpotdar or Dr. Sun know if your child's dental appearance is causing them emotional trauma. Often they can customize a solution that can greatly improve your child's dental appearance.

Recognizing And Treating Your Child's Misaligned Jaw

What If I Put Off Treatment?

Putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your child's smile.

In certain conditions, children may require surgery later in life to correct problems that may be prevented with early treatment. Early treatment is most effective for achieving lasting results.

About the Two Phases of Treatment

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 (conditions like those listed above are often caused by inadequate development of one or both jaws).

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.

  • 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.
  • 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 first free consultation, Dr. Sarpotdar or Dr. Sun 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.

  • 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.

Different orthodontic issues in children warrant different types of treatment and different times. Contact Icon Orthodontics to schedule a free consultation with Dr. Sarpotdar and Dr. Sun. They will determine if it is an appropriate time to start treating your child.