We know that the goal for orthodontic treatment is to get the patient’s teeth aligned in a way so that the bite comes together and functions correctly.
Sometimes, the whole of an orthodontic treatment plan can (and often MUST) be segmented over multiple “phases.” Different orthodontic issues may be best treated at different times in a patient’s life.
This blog post will break down what “Phase I, II and III” of orthodontic treatment typically entails (with the condition – as always – that every patient’s mouth and needs are unique!)
Begin at the Beginning
“Phase I” of orthodontic treatment is also known as the interceptive phase, also referred to as “Early Treatment.” We get a LOT of great questions from parents and guardians about Phase I specifics: when will my child need it, why does my child need it, what issues with their teeth will warrant it, and so forth. Again, all great questions. Let’s break it down:
Phase I is typically conducted before a child’s permanent teeth have all completed eruption. The goal of this early treatment is to help the upper and lower jaws fit together effectively and give room for those permanent teeth to cleanly erupt. This treatment occurs (with exceptions, of course), when the patient is between 6 and 10 years of age, when they start to lose their baby teeth. This age range is an optimal time for an orthodontist to assess if the child is experiencing or may experience disturbances in jaw growth or tooth development (The American Association of Orthodontists recommends that all children get a checkup with an orthodontist no later than 7 years of age).
This treatment is designed to do a lot of heavy lifting, with the end goal of giving the permanent teeth a clear path to erupt. The treatment duration typically lasts 12 months; it is not uncommon for orthodontic brackets to be bonded to only the necessary teeth (as opposed to a “full mouth” of braces). Appliances such as a palatal expander or a removable bite plate may also be used.
Upon completion and removal of appliances, the patient will usually be fitted for a retainer or a spacer to maintain treatment results.
A Second Round to Strengthen Your Smile
“Phase II” treatment is designed to align the teeth for maximum esthetics, function and stability. This treatment course typically occurs when the patient has most to all of their permanent adult teeth and is right at the cusp of their “adolescent growth spurt” (Again, there are exceptions!).
What we’re on the look-out for in Phase II are any underlying dental issues that may impact the final position of the teeth. If left un-treated, even seemingly benign orthodontic issues can snowball into major problems. This treatment phase will have the most impact on the appearance of your teeth, bite, and smile as you mature from an adolescent to an adult. Phase II treatment can last anywhere from 12 to 30 months.
If I “Did Phase I” do i need to Do “II” Too?
A perfectly fair question, though this is certainly not a “pick one or the other” scenario. While not every case will warrant two full phases of treatment, successful completion of early treatment is not a guarantee that a later treatment will be unwarranted.
Additionally, while Phase I may make Phase II easier and lend the latter for an expedited treatment time, that is also not a guarantee. As we said earlier, every patient’s needs are unique. Plus, the patient’s willingness to comply with treatment instructions in both treatment phases also plays a major factor.
Koch Orthodontics has guided many patient’s through both phases of treatment, taking the needed time to study the patient’s distinct needs and work closely and transparently with the patient, their dentist, and their family to discuss an appropriate approach and realistic timeline for executing both phases of treatment.
And Finally (But Equally Important)…
“Phase III” – the retention phase! When the teeth have been correctly aligned, fixed braces and removable devices will be removed and discontinued. We will create a custom retainer for routine wear to ensure the teeth do not begin to shift back to their original positions. Retainers need to be worn for a specified amount of time per day for a specified time period. During the retention phase, the patient’s jawbone reforms around the realigned teeth to fully stabilize them in the correct alignment.
Please – be judicious about wearing your retainer. If you have questions, if you feel the retainer is not fitting comfortably in your mouth – let us know. A lapse in treatment allows your teeth to go crooked again.
A Successful Two Phase Case
Here’s a case study to demonstrate the full scope of “Two Phase Treatment.”
This patient (pictures to the right) went through Phase I orthodontic treatment in our office along with Phase II orthodontic treatment (when all of her adult teeth had erupted).
Phase I orthodontic treatment included a rapid palatal expander and a limited phase of braces for the upper teeth. The purpose of interceptive treatment was to address her posterior crossbites and make room for her upper canines to erupt into the arch.
After 14 months of interceptive treatment, her braces were removed and a fixed retainer was placed on her upper teeth as seen in the middle photo.
At the end of Phase I orthodontic treatment, removable retainers can also be used to retain the position of the teeth.
One year later, our patient lost all of her baby teeth and then she began her second phase of orthodontic treatment. Her Phase II orthodontic treatment included 16 months of upper and lower braces. Check out this patient’s stellar “Before & After” photos – click each picture to enhance!
Before Phase I Treatment
After Phase I Treatment
After Phase II Treatment
Treatment Tailored to Your Teeth
As a “Family Practice with a Family Focus,” we make the effort to treat a patient through both Phase I and II of orthodontic treatment whenever it’s advantageous. We can more closely monitor patient progress, apply the latest orthodontic technological advances, and most importantly – get to know you and your family, creating a “team-focused” investment to truly “empower your smile!”
Questions about treatment phases, orthodontic care or oral health in general? Contact us through our website or call us at (585) 243-3174. Remember – initial consultations are free, and a referral from a general dentist is not required.