Interceptive Two-Phase Orthodontics: A special Kind of Orthodontic Treatment
First-Phase Treatment (Ages 7 to 10)
The goal of first-phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to proportionately relate the upper and lower jaws to each other. Children sometimes exhibit early signs of severe problems as they grow and develop. An upper or lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 7 are found to have his jaw discrepancy, they are sometimes candidates for early orthodontic treatment.
Because they are growing rapidly, children can benefit enormously from an early interceptive phase of orthodontic treatment utilizing appliances that properly re-direct the growth of the jaw and align teeth. Thus, a good foundation and dental arches, can be established, providing adequate room for eruption of all remaining permanent teeth. This early correction may prevent later removal of teeth to correct overcrowding and/or prevent surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with just braces alone or ultimately require the unnecessary removal of permanent teeth.
Orthodontic records will be necessary to determine the type of appliances to be used, the durations of treatment times and the frequency of visits. Records consist of models of the teeth, digital x-rays, and photo images. First phase treatment is usually 6 to 12 months.
Resting Period (3 to 5 years)
In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices are not usually recommended since they interfere with tooth eruption and inhibit jaw growth. It is best to allow the jaws and permanent teeth some freedom of growth and development while final eruption occurs. A successful first phase will have created room for teeth to find proper eruption paths. Otherwise, they may become severely displaced.
Periodic recall appointments for observation are necessary, usually on a 9-month basis during this resting phase of treatment.
Second-Phase Treatment (11-14 years)
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 and wear together properly. They will be more stable and stay healthy as well as look attractive. This is the goal for the second phase of treatment.
The second phase is initiated when all the permanent teeth have erupted and usually requires braces on all the teeth for an average of 9 to 18 months for ideal bite alignment. Final retainers are worn after this phase since growth is completed.
Advantages of Two-Phase Orthodontic Treatment
Interceptive two-phase orthodontic treatment is a process that encompasses jaw development, tooth straightening and physical facial changes. The major advantages of two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, aesthetic result that will remain stable without tooth removal.
The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment, for someone with severe discrepancy, is having to face the possibility of permanent tooth extraction or having a compromised result that may not be as stable.