Roseburg Office
1729 W Harvard Ave. Suite 3
Roseburg, OR 97471
(541) 673-0924

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Coos Bay Office
375 Park Ave.
Suite 7
Coos Bay, OR 97420
(541) 267-3060

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Two-Phase Treatment

two phase treatment

What is Phase I/Phase II orthodontic treatment and how is it different from other orthodontic treatment that takes place?

There seems to be a lot of confusion about why some children start orthodontic treatment early (Phase I), only to have treatment again, when all the permanent teeth have erupted (Phase II), and why some children have orthodontic treatment only once, after all the permanent teeth have erupted (Comprehensive Treatment).

What is Phase I Orthodontic Treatment?

Phase I orthodontic treatment, or "Early Treatment," is often recommended to patients ages 7-10 who will benefit from beginning orthodontic treatment prior to the loss of all their primary teeth.

Should all children have Phase I orthodontic treatment?

No. Phase I treatment is recommended for children who have moderate to severe bite problems, such as "cross-bite" (the upper teeth fitting on the inside of the lower teeth), an underbite or an open bite. It may also be recommended for severely malaligned, or crowded, teeth.
One goal of Phase I treatment is to create a more favorable environment for the eruption of the permanent teeth. This will decrease the amount and complexity of treatment later, such as having to extract teeth. Phase I treatment can include alteration of uncoordinated jaw-growth patterns, as many poor bites are related to the upper or lower jaw growing faster or slower than the other jaw. Early growth guidance treatment can help coordinate this jaw growth. This early correction may prevent surgical procedures to align the upper and lower jaws.
Typically, a patient requiring early treatment will have a removable appliance (similar to a retainer) and/or 4-6 braces on the erupted permanent teeth. Treatment may also involve an expander if a cross-bite or severe crowding is present. Specifics of treatment will be discussed thoroughly with you and your child at the consultation.

Will treatment be needed again, later?

Most patients will require a second phase of treatment after the remainder of the permanent teeth erupt (Phase II treatment), although occasionally further treatment is not necessary. This later treatment will be shorter and less complex than what would have otherwise been necessary. For example, the removal of permanent teeth may be avoided by having Phase I treatment. This second phase of treatment is often just to align all the teeth into a perfect position, or "detail" the bite — with the bulk of the correction being completed in the first phase.
Timing and type of treatment are dependent upon the problem and its severity, but typically Phase I treatment will take 6-12 months and generally occurs between the ages of 7 and 10. The remainder of the permanent teeth will usually take 12-24 months to erupt, after which your child will be ready for "final finishing" or "Phase II" treatment. This second phase of treatment can take from 12 to 24 months.

What is Comprehensive Treatment?

Comprehensive orthodontic treatment refers to having conventional braces, sometimes with another orthodontic appliance at the same time, when most of the permanent teeth have erupted. On average, this occurs at age 11-12. A patient who requires comprehensive treatment will only need this one stage of orthodontic treatment, which usually takes from 12 to 30 months. These patients don't have severe bite problems or crowding that requires early intervention. Or they may be patients who do have a severe bite problem, like a moderate to severe overbite, but treatment would be better suited at this age when they are going through a growth spurt that will aid in the correction of that particular problem.

Why does the American Association of Orthodontists recommend all children be seen by an orthodontist at age 7?

By age 7 the permanent teeth are starting to come in and you can tell at this point if a patient has adequate space for the remaining permanent teeth. If there is a significant problem with crowding, steps can be taken to facilitate the eruption of the permanent teeth. Also, a person's jaw relationship is pretty much established at this point or is starting to be established. This is a great opportunity to see if there is an imbalance in the jaw relationship and correct it early before it becomes a significant problem. In summary, early screening can help prevent more complicated treatment later!

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