Phase I Treatment

As children grow and develop, they may exhibit early signs of jaw problems. The goal of first phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other.

Children sometimes exhibit early signs of jaw problems as they grow and develop. For instance, too much or too little jaw growth results in an incorrect jaw relationship, which in turn affects the profile and bite. If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment.

The goal of Phase I is to “level the playing field,” so that a child is given the best chance at developing a smile that is both functionally correct and cosmetically pleasing. Because children grow so rapidly, they can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws.  Therefore, a good foundation can be established, providing adequate room for eruption of all permanent teeth. Completion of Phase I may eliminate the need for removal of permanent teeth and can sometimes shorten later Phase II Treatment time. At your initial exam, Dr. Appel will honestly explain whether early “Phase I” Treatment will benefit your child.

Observation (“Resting”) Period

During this time, the last of the baby teeth will be lost and the remaining permanent teeth will erupt. A successful first phase will have increased space for the permanent teeth, often preventing SEVERELY crowded or IMPACTED teeth. Periodic visits are scheduled in order to monitor growth and development. It is best to allow the existing permanent teeth some freedom of movement while final eruption of teeth occurs. A successful first phase will often create room for teeth to find an eruption path. Otherwise, they may become impacted or severely displaced. At times, selective removal of baby teeth may be necessary in order to guide or enhance the eruption of the permanent teeth. In other words, 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.

Movement & Retention

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan established. Certain types of appliances were used in the first phase, as dictated by the problem.

Phase II Treatment

The nature of treatment in this “full braces” phase is more tooth-related than jaw-related. The goal is to achieve a pleasant smile and a bite in which the teeth function properly, not only with each other, but with the lips, tongue, and cheeks as well.

Orthodontic records are again taken prior to beginning Phase II in order to evaluate the patient’s current status following growth and development. The second phase is initiated when all permanent teeth have erupted, and usually requires braces on all the teeth. Retainers are worn after this phase to ensure you retain your beautiful smile.