What is Two-Phase Orthodontic Treatment?

What is Two-Phase Orthodontic Treatment?

Traditionally, we wait until your child has lost most baby teeth before we initiate orthodontic treatment. However, some orthodontic problems are better corrected when he is younger. We call this two-phase orthodontic treatment.

Two-phase orthodontic treatment is the process of combining craniofacial changes (Phase One) and tooth straightening (Phase Two) to achieve a smile that is beautiful, healthy and stable.


Phase One- The goal of phase one treatment is to direct the growth and relationship of the upper and lower jaws with craniofacial appliances. This establishes an orthodontic foundation and provides adequate room for the eruption of permanent teeth. Phase One starts around ages 7 to 10.

Rest Period- The resting period follows Phase One and is a time for your child’s permanent teeth to erupt without interference from active orthodontic appliances. Appointments every six months will be used to monitor your child’s teeth during this period.

Phase Two- The second phase of treatment involves moving permanent teeth to their permanent position with braces. Thanks to effective Phase One treatment, teeth are in much better position and braces often won’t have to be worn as long as they would have if we had postponed treatment until adolescence.

Not every child is a candidate for two-phase treatment, but those who are benefit tremendously. Correcting a malocclusion early allows us to make room for permanent teeth to erupt and improve bite mechanics, lessening the need for extraction and invasive surgeries later on down the road.

Other Benefits of Two-Phase Orthodontic Treatment

  • Function –Phase One creates better jaw alignment, so your child’s speech and chewing function optimally. This also means a reduced risk for temporomandibular joint disorder and pain.
  • Facial symmetry- Poor oral development can affect the appearance of your child’s teeth and facial appearance. Asymmetries and certain undesirable characteristics such as sunken cheeks can be avoided with craniofacial adjustments.
  • Short time in braces- Phase One treatment lessens the severity of your child’s malocclusion, which potentially means spending less time wearing braces as an adolescent.
  • Long-term stability- Correcting jaw discrepancies early and letting them “rest” before orthodontic treatment increases the longevity of the results achieved in Phase Two.

“Patients who are good candidates for two-phase treatment are diagnosed early, which is why it is so important to follow the American Association of Orthodontists’ recommendation to have your child screened by an orthodontist by age 7, or at the first sign of a problem,” says Dr. Mark Bronsky.

The following malocclusions can be spotted early and are best treated in two phases.

  • Open bite- The back molars fit together, but the upper and lower front teeth do not overlap. Instead, there is an opening straight into the mouth.
  • Overjet- Most would recognize this malocclusion as buckteeth. It can be hereditary, but also may be caused by extended pacifier use or thumb-sucking. Thumb-sucking that has not ceased by the time your child’s permanent teeth start to erupt may put his oral development at risk.
  • Underbite – When lower teeth protrude farther out than upper teeth. Your child’s lower jaw may appear crooked or as though it is protruding if he has an underbite.
  • Crossbite- When any of the upper teeth fit into the wrong side of the lower teeth. Your child’s chin may appear to be off-center with the rest of his facial features if he is suffering from a crossbite.

Other problems to look out for include excessive thumb-sucking, mouth breathing, and premature or delayed loss of baby teeth.

Call today to book your child’s orthodontic evaluation by age 7 so we can determine if he might benefit from Phase One treatment.

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