Two-phase treatment means a short course of orthodontics while a child is still growing, a rest period of a few years, and then comprehensive treatment once the permanent teeth are in. Many children who need orthodontics only need one phase, as teenagers. Whichever approach we recommend, it is because it is the right plan for your child.
Here we explain what the two phases involve and how we decide whether your child will benefit from them.
Is Two-Phase Treatment Right for My Child?
For some children, yes. Dr. Rosenbloom will tell you whether your child is one of them.
Two-phase treatment is valuable for a specific set of problems, most of which involve the size or relationship of the jaws rather than the position of individual teeth. For those cases, the first phase takes advantage of growth that will not be available later, so it can accomplish something the second phase could not do on its own.
For many other cases, such as straightforward crowding, one comprehensive course of treatment at around age twelve works just as well as starting at eight.
Our approach is simple: we recommend an early phase only when it will accomplish something that would be difficult or impossible later.
Phase One
The first phase typically runs six to twelve months, somewhere between ages seven and ten, and it targets one specific problem rather than aligning the whole mouth.
The most common reasons are a narrow upper jaw needing expansion while the palate can still widen, a crossbite that could cause the jaw to grow unevenly, upper front teeth that stick out far enough to be at risk of injury, or a habit such as prolonged thumb sucking that is moving teeth.
The appliance is usually an expander, a partial set of braces on a few teeth, a space maintainer, or a habit appliance. It is not a full set of braces.
The Resting Period
Between the phases, most children simply grow. This stretch usually lasts one to three years while the remaining permanent teeth come in.
There are no appliances during this period for most children, though some wear a retainer or a space maintainer to hold what the first phase achieved. We see them periodically to track how teeth are coming in, and those visits are typically brief.
Parents sometimes worry during this stage, because teeth can look uneven while they are coming in. That is completely normal, and the second phase will bring everything together.
Phase Two
The second phase is comprehensive treatment, usually with a full set of braces, once essentially all the permanent teeth are present. This is generally somewhere between ages eleven and thirteen, and it commonly runs eighteen to twenty-four months.
Phase two aligns everything and finishes the bite, creating your child’s final result.
When the first phase was needed, the second is often simpler than it would have been, because the foundation is already in place. Most children who have an early phase will still need a second phase later, and we will explain why at the start.
Retainers follow, as they do after any course of orthodontics. See retainers.
How We Decide
At the age-seven check, we look at jaw width, jaw relationship, how the teeth are coming in, and any habits. Frequently, no early intervention will be necessary, and we will simply see your child again in a year or so to keep an eye on growth.
If early treatment would help, we explain exactly what the first phase would achieve and what could happen if it is skipped, so you can make a confident decision for your family.
More on the age-seven visit is on our early orthodontic treatment page.
Book a Free Check
The exam is free, takes 30 minutes to an hour, and needs no referral. If your child does not need an early phase, we will let you know.
Call or text (845) 471-1186, or request an appointment online. We are at 1145 Route 55, Suite 1 in LaGrangeville.
Frequently Asked Questions
Is two-phase orthodontic treatment legitimate?
Yes. It works well for certain growth-related problems, such as jaw width and jaw relationship, and we recommend it only when it will help your child. When the issue is simply crowded teeth, one phase of treatment later is usually the better plan.
Why do orthodontists do two phases instead of one?
Because some corrections depend on growth that will not be there later. Widening a jaw, guiding how the jaws meet, and redirecting badly erupting teeth are all easier or only possible while a child is growing. Everything else can wait for the permanent teeth.
How long does phase two last?
Usually eighteen to twenty-four months, which is comparable to a standard course of braces. Complex cases run longer.
What happens in between the two phases?
Mostly growing. The resting period generally lasts one to three years while the remaining permanent teeth arrive. Some children wear a retainer or space maintainer through it, and we check progress periodically.
Will my child definitely need a second phase?
In most cases, yes. The first phase corrects a specific problem, such as jaw width or a crossbite, but it does not align the whole mouth. Most children who have an early phase will still need a second phase later, and Dr. Rosenbloom will explain what to expect from the start.