Phases of Treatment

With younger children (ages 7-11), who have facial deformities, chewing difficulties, or psychological problems due to peer group teasing, sometimes the best way to treat the child is with two phases of orthodontic treatment. An early interceptive phase may be necessary to correct the more obvious problems, and then treat the routine problems later in a second phase. Take a look at How Children Grow for more extensive information on treatment planning.

The first phase of treatment is to make the younger child appear more normal for their age group, and is accomplished with short term partial braces, or a removable appliance. A second phase occurs later in the teens using full braces to detail the final position of the teeth.

Phase one types of Treatments: With limited objectives which can be treated in less than a year:

• Palatal expansion can be performed after the upper first molars erupt using an appliance to widen the upper jaw.
• Alignment of severely crowded or severely protrusive teeth. Partial braces in only one arch is usual, and time in the braces is limited. Generally, the objective is to correct some major malformation or abnormal eruption pattern, and then hold that position until more growth occurs.
• Habit correction involving fingers, thumbs or a dreaded tongue thruster.
• Full tooth alignment and final positioning of the jaws. This phase of treatment is the typical comprehensive teen orthodontic treatment initiated at age 11 to 12.

The advantages of phase one or early interceptive correction are: improved facial appearance, improved chewing during critical formative years, and drastic improvement cosmetically. Results with the first phase usually occurs within 6 to 12 months with normal growth.

The ultimate goal is a 'normal' face and a pretty smile which is pleasing and functionally correct. The earlier treatment is started, the sooner we can establish a normal environment for natural growth and development.

Psychologically, two phase treatment addresses the severe problem early, and avoids the social implications associated with not being 'normal'.

To review: instead of one comprehensive course of treatment as a teenager, the idea of two phase treatment is to allow the young, growing, child to have deforming problems solved early. We don't want them to suffer with these problems through the years when we usually are waiting on teeth to erupt and the face to grow. The typical age when full treatment is started is age eleven to thirteen. With phase one treatment, we are treating problems in the seven to nine year old range, so the child and the parents do not have to deal with a facial deformity until the usual age of usual orthodontic treatment.