Two-Phase Treatment

Creating a foundation for a lifetime of beautiful teeth with

Phase 1, Early Interceptive Treatment

Planning early can save your child’s smile later. Because young children are growing rapidly, many can benefit from an early phase of orthodontic treatment to intercept developing bite problems. Phase 1, which is often called ‘early interceptive treatment’, utilizes appliances that can influence the growth relationship and shape of the upper and lower jaws and provide more space for the permanent teeth. By providing a good foundation early it may prevent the need for removal of permanent teeth later to correct overcrowding and/or surgical procedures to align the upper and lower jaws.

Advantages of Phase 1, Early Interceptive Treatment:

1. To develop the jaw size in order to create more room for the permanent teeth to find an eruption path. The goal is to attempt to prevent permanent teeth that have not erupted from becoming "impacted" or severely displaced. Permanent teeth that do not have a path to erupt are often referred to as being "blocked out," which when left untreated can contribute to or cause damage to adjacent permanent teeth and even permanent tooth loss.
2. To improve the relationship of the upper and lower jaws to each other. Children sometimes exhibit early signs of jaw 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 are found to have jaw discrepancies, they are candidates for early orthodontic treatment to attempt to avoid more invasive orthodontic or surgical procedures when they are older. Children that have an Early Treatment phase will almost always need more orthodontic therapy when they are older.

A resting phase, often called “Observation Recall”, begins when the early treatment phase has been completed

At the end of Phase 1 while we are waiting for the remaining permanent teeth to erupt, retainers may or may not be recommended by Dr. Crawford. She will make the decision about whether or not retention appliances will be beneficial during the resting phase based on whether the retainers will interfere with the eruption of the remaining permanent teeth. Sometimes it is best to allow the existing permanent teeth some freedom of movement and other times it is best to hold the existing permanent teeth to prevent them from drifting into the space needed for the erupting permanent teeth.

At the end of the first phase of treatment the teeth are not in their final positions. This will be determined and accomplished in the 2nd treatment phase that usually occurs between the ages of 12 and 14. During the resting phase, called "observation recall," it is often beneficial to request the removal of certain primary (baby) teeth early, rather than waiting for them to exfoliate (fall out) on their own. You may hear Dr. Crawford refer to this as ‘directing traffic’ or ‘guided growth.’ Removing primary teeth ahead of schedule is requested when Dr. Crawford feels it is important to try to enhance and improve the eruption pattern of the permanent teeth. In most cases, Dr. Crawford asks to see each patient in "observation recall" each six months. At each patient’s six-month recall appointment a digital radiograph is taken in order to be able to contrast and compare the changes in the relationships of the unerupted and erupting permanent teeth.

What if I put off doing early treatment when it has been recommended?

In many cases, if early, interceptive treatment is needed and not done it may not be possible to achieve the same treatment goals later. Also, when a jaw or bite problem is left untreated in a growing patient the risks of jaw surgery, impacted teeth, permanent teeth extraction and compromised results significantly increase.