The American Association of Orthodontists recommends that children be examined at 7-8 years of age. The reason for this recommendation is approximately 20-25% of the population of 7-8 year olds can benefit tremendously from a treatment protocol split into two phases.

Phase I: Phase I treatment addresses specific problems to establish a more normal facial balance. These problems include extreme jaw bone disharmony such as underbite, crossbite, and extreme protrusion (overbite). Other problems like extreme crowding, or muscular imbalances such as tongue thrusting, thumb sucking or lip biting also benefit from early intervention. If using an analogy of building a house, Phase I would be the foundation work.

Resting Period: In this phase, the remaining permanent teeth are allowed to erupt. 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. Sometimes if a patient has precocious development, Phase II will begin without a rest period.

Phase II: The placement of the teeth in their ideal positions within the jaw occurs in Phase II. To continue the analogy, this is building the house upon the foundation. A full set of braces is typically used, but sometimes a retainer or clear aligners are utilized, depending on the results of Phase I. Most orthodontic results are determined by 2 factors: growth and cooperation of the patient.

Typical Time Line:

What if I put off treatment?

The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment for someone with a jaw discrepancy or musculoskeletal imbalance is facing the possibility of a compromised result that may not be stable. There is also a much greater chance of extractions and/or jaw surgery to correct the musculoskeletal problems.

Summary

We will use a two-phase treatment program when it is indicated because of what we are able to accomplish in altering the jaw structure and oral environment. This early approach to treatment allows correction of a skeletal problem as a child is growing, which is the preferred method of treatment for the correction of the previously mentioned types of orthodontic and orthopedic problems.