Two Phase Orthodontic Treatment
Two-phase orthodontic treatment is one of the most important tools we use at Smile & Co. Orthodontics to guide healthy jaw growth, support proper tooth development, and set children up for lifelong confident smiles. Under the care of Dr. Sam Kadan and Dr. Nicolette Almer, two-phase treatment provides a proactive, science-backed way to address orthodontic issues at the ideal moment, giving your child the best possible foundation for their permanent teeth.
The American Association of Orthodontists recommends that children receive their first orthodontic evaluation around age seven. At this early stage, we can identify developing issues and determine whether two-phase treatment is the most beneficial path forward. Research shows that roughly one in every ten children can benefit from a two-phase approach.
What Is Two-Phase Treatment?
Two-phase orthodontics includes two distinct stages designed to correct different aspects of jaw and tooth development. During your child’s initial exam, Dr. Kadan or Dr. Almer assess jaw growth, bite patterns, and emerging permanent teeth to determine whether early intervention is recommended.
Phase I Treatment
Phase I focuses on guiding the jaw’s growth and development while a child still has baby teeth. The goal is to create a healthy foundation for permanent teeth and correct early structural issues before they become more complex.
Common issues treated during Phase I include:
- Severe crowding
- Tooth eruption problems
- Large overbites, underbites, or deep bites
- Open bites
- Crossbites
- Protruding front teeth
- Narrow dental arches
- Harmful oral habits such as thumb-sucking or tongue thrusting
Early treatment often prevents or minimizes the need for permanent tooth extractions later on.
Phase II Treatment
Phase II takes place during the teen years once most or all permanent teeth have erupted. This phase uses standard orthodontic treatments, such as braces or Invisalign®, to align the adult teeth and finalize your child’s bite.
Two-Phase Braces: What Does It Mean?
“Two-phase braces” refers to using orthodontic appliances twice, first during early childhood and again during adolescence. The first set helps create space and improve jaw alignment. The second set focuses on straightening the permanent teeth and perfecting the bite.
This approach leads to healthier alignment, improved facial balance, and significantly more predictable long-term results.
What Are the Advantages of Two-Phase Treatment?
Two-phase orthodontic care combines early jaw correction with later tooth alignment for a comprehensive, long-lasting result. Benefits include:
- Improved facial growth and jaw alignment
- Better eruption paths for permanent teeth
- Reduced need for extractions or jaw surgery
- Correction of harmful oral habits
- Stronger long-term bite stability
- Improved speech development
- Shorter and simpler Phase II treatment
- Enhanced confidence and aesthetics as teeth erupt
What Happens If Treatment Is Delayed?
Delaying recommended Phase I treatment can lead to:
- More difficult or invasive treatment later
- Limited treatment options after jaw growth slows
- Higher risk of extraction or surgery
- Worsening of bite imbalances
Early intervention ensures we can guide growth, something we cannot do once the jaw matures.
What Is Phase I Orthodontic Treatment?
Phase I treatment is typically recommended between ages 7 and 10, when a child still has baby teeth. Its primary purpose is to promote proper jaw development so adult teeth can erupt smoothly.
Benefits of Phase I Treatment
Phase I orthodontics:
- Improves the width of the dental arches
- Reduces or eliminates future jaw surgery needs
- Positively influences jaw growth
- Helps correct harmful oral habits
- Boosts smile aesthetics and confidence
- Minimizes the need for future extractions
- Improves speech development
- Shortens Phase II treatment
- Supports proper eruption of permanent teeth
Do All Children Need Phase I Treatment?
Not all children require early treatment. Dr. Kadan and Dr. Almer may recommend Phase I for concerns such as:
- Open bites, underbites, or crossbites
- Severe crowding or misalignment
- Uneven jaw development
- Early bite problems that could worsen over time
Phase I creates the ideal conditions for permanent teeth to erupt correctly and reduces the need for complex interventions later.
What Is the Resting Period?
After Phase I, children enter a resting period where remaining permanent teeth erupt naturally. Retainers may or may not be needed depending on the case. We schedule check-ins every six months to monitor growth, spacing, and tooth eruption.
Some baby teeth may be removed to support proper development. A successful resting period means Phase II treatment will be smoother and shorter.
What Is Phase II Orthodontic Treatment?
After the resting period, Phase II usually begins during the early teen years. This stage aligns the permanent teeth and creates the final, beautiful smile.
Typical timelines include:
- Phase I: 6–18 months
- Resting period: 12–24 months
- Phase II: 12–24 months
Because Phase I addressed foundational issues early, Phase II treatment is often significantly shorter and more efficient.
What Is Comprehensive Orthodontic Treatment?
Some children only need one stage of treatment, called comprehensive treatment, which usually begins around age 12 and lasts 12–30 months. Comprehensive treatment is recommended when:
- Teeth are not overcrowded
- Bite issues do not require early correction
- Growth patterns can be addressed in one stage
Why Does the AAO Recommend Orthodontic Exams at Age 7?
Age 7 is the perfect time to assess jaw development and the eruption of permanent teeth. Early evaluation helps Dr. Kadan and Dr. Almer detect abnormalities and create a proactive plan to prevent more complex problems later.
Frequently Asked Questions
Two-phase orthodontics can feel unfamiliar to many parents, especially if they never had early treatment themselves. To help you feel confident and informed, we’ve answered the questions families in our community ask the most, so you understand how two-phase care works, why it’s recommended, and what it means for your child’s long-term smile.
How do I know if my child truly needs two-phase treatment or just braces later on?
It’s a great question—and one many parents have. Not every child needs two separate phases of care. Two-phase treatment is recommended only when early jaw guidance can make a meaningful difference to your child’s health, comfort, or long-term alignment. After evaluating growth and X-rays, Dr. Kadan or Dr. Almer will help you understand exactly why early treatment is or isn’t needed. If Phase I isn’t necessary, your child may simply be monitored until the ideal time for braces or Invisalign®.
Can two-phase treatment reduce the chance my child will need jaw surgery later?
Yes. One of the biggest benefits of early intervention is correcting jaw growth while a child is still developing. Guiding the upper and lower jaws early can prevent severe bite problems from becoming surgical concerns in the teen years. Many families choose two-phase treatment specifically because it helps avoid more complex treatment down the road.
What types of appliances are used in Phase I treatment?
Phase I may involve expanders, limited braces, space maintainers, or habit-correction appliances, depending on your child’s needs. These appliances are designed to be gentle and kid-friendly. We take time to teach children and parents how they work and how to care for them so the process feels easy and manageable.
Is two-phase treatment more expensive than traditional braces?
The cost varies depending on your child’s needs, but many families are surprised to learn that early treatment can actually reduce total costs by preventing more serious issues later. During your consultation, we provide a transparent breakdown of fees, insurance coverage, and flexible payment options so you can make the best decision for your family.
What happens if we delay or skip Phase I treatment even if it’s recommended?
Waiting may limit what we can correct later. Once the jaw stops growing, certain issues, like crossbites, narrow arches, and severe bite imbalances, become more difficult to fix and may require more invasive treatment. Early care allows us to guide growth at the ideal time, which is something that can’t be done later.