Why are some patients treated in two phases?
Dr. Chaffee, as well as the American Association of Orthodontists, recommends that patients are seen for initial examination at about age 7. The vast majority of patients are best treated at a later age, but there are a few types of orthodontic problems that are best treated at an early age. Such problems include crossbites, some open bites, underbites, and rarely, some severely crowded cases.
What is the advantage of two-phase orthodontic treatment?
Early treatment is recommended in only a few situations. For example, upper jaw expansion is used if the jaw is too narrow and a crossbite exists. Cessation of certain habits, such as thumb sucking habits, is also important to resolve at an early age. Studies show that patients with class III bites (underbites) can have greater correction if treatment is begun at an early age. In other words, early treatment can simplify later treatment.
Seeing patients at an early age allows us to rule out certain problems, identify current and anticipated orthodontic problems, and to advise you of what to expect and plan for in the next few years.
Making records to determine your 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.
In those rare cases that need early treatment, the remaining permanent teeth are allowed to erupt in the resting period. Retainers are sometimes not used since they may interfere with eruption of the remaining teeth. It is best to allow the existing permanent teeth some freedom of movement while final eruption of teeth occurs. A successful first phase will have created room for teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.
Monitoring your 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.
Second Phase Treatment: Stay healthy and look attractive
The goal of the second phase, and in comprehensive treatment, 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.
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. The second phase is initiated when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 18-24 months. Retainers are worn after this phase to ensure you retain your beautiful smile.