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Two-Phase Treatment

Two-phase orthodontic treatment is a specialized process that combines tooth straightening and physical, facial changes. The purpose of two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, and aesthetic result that will remain stable throughout your child’s life.

Putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your child’s smile. Early treatment is most effective for achieving lasting results.

Phase One

Phase One

The goal of Phase One treatment is to help the jaw develop in a way that will accommodate all of the permanent teeth and improve the way the upper and lower jaws fit together. Children often exhibit early signs of jaw problems as they grow and develop. An upper jaw that is growing too much or is too narrow can be recognized at an early age. If children over the age of six are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Also, if children around the age of eight have crowded front teeth, early treatment can prevent the need to extract permanent teeth later.

Children benefit tremendously from early-phase treatment. Receiving early treatment may prevent the removal of permanent teeth later in life, or the need for surgical procedures to realign the jaws.

Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits. Records consist of models of the teeth, X-rays, and photographs. During your child’s initial consultation, the doctor will take records to determine if early treatment is necessary.

Resting Period

In this phase, the remaining permanent teeth are left alone as they erupt. Retaining devices may not be recommended if they would interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement. A successful first phase will have created room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.

At the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.

Phase Two

The goal of the second phase is to make sure 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 together properly. Phase Two usually involves full upper and lower braces.

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was established. Certain types of appliances were used in the first phase to correct and realign the teeth and jaw. The second phase begins when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure your child retains his or her beautiful smile.

Palatal Expanders

The palatal expander “expands” (or widens) your upper jaw by putting gentle pressure on your upper molars each time an adjustment is made. The animation below will instruct you about when and how to adjust your expander. When you achieve the desired expansion, you will wear the appliance for several months to solidify the expansion and to prevent regression.

To adjust the expander:

  1. Place the key in the hole until it is firmly in place.
  2. Push the key toward the back of the mouth. You will notice the fender will rotate and the new hole will appear. The rotation stops when the key meets the back of the expander.
  3. Press back and down toward the tongue to remove the key. The next hole for insertion of the key should now be visible.

Surgical Orthodontics

Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws, and the hard and soft tissues of the oral and maxillofacial region. It is a recognized international surgical specialty, and it is one of the nine specialties of dentistry recognized by the American Dental Association.

Oral and maxillofacial surgeons are the only recognized dental specialists who, after completing dental school, are surgically trained in an American Dental Association-accredited hospital-based residency program for a minimum of four years. They train alongside medical residents in internal medicine, general surgery and anesthesiology, and also spend time in otolaryngology (ear, nose, and throat), plastic surgery, emergency medicine, and other specialty areas. Their training focuses almost exclusively on the hard and soft tissue of the face, mouth, and jaws, and their knowledge and surgical expertise uniquely qualify them to diagnose and treat the functional and aesthetic conditions in this part of the body.

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