Plunkett Orthodontics

Two-Phase Treatment

two phase treatment


What is the advantage of two-phase orthodontic treatment?

Two-phase orthodontic treatment is a specialised process combining tooth straightening and physical, facial changes. The purpose of two-phase treatment is to maximise the opportunity to accomplish the most satisfactory, functional and aesthetic result, for the bite and smile.

What if I put off treatment?

Putting off treatment can result in the need for more complex treatment later in life, that may not completely fix your bite and smile. Early treatment can offer the simplest, most effective way to achieve a satisfactory functional bite and smile.

Phase One - Orthopaedic Treatment

At the beginning of Phase One, orthodontic records are taken and a diagnosis and treatment plan established. Certain types of fixed or removable appliances are used in the first phase, to correct and re-align the teeth and jaws.

While sometimes orthodontic treatment can wait until all the baby teeth are lost (usually 11-13 years old), it is often important for a first stage of treatment to start much earlier than this.  Children who have a disharmony between the upper and lower jaw positions can greatly benefit from early treatment, where an orthopaedic (jaw bone change) effect is aimed for, using the patient’s own facial growth.  The timing of this treatment is critical, as it is only effective during periods of significant growth.  Such treatment can involve different appliances, such as fixed or removable functional appliances, headgear, partial braces and jaw expansion appliances.

All have their place in orthodontics and if used in the correct way, at the correct time, for the appropriate patient, much improvement can be gained.  Early treatment is aimed at correcting the fundamental jaw bone relationships. Braces are usually still required as a second stage of treatment, for final alignment of the teeth and correction of the bite.

The advantage of this approach is not only a better jaw relationship and improved function and facial profile, but sometimes a shorter, less complicated phase of treatment with braces.  Successful early treatment can help avoid the need for extraction of permanent teeth and even the need for corrective jaw surgery.

Resting Period

After completing Phase One treatment, 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.

  • Monitoring growth, development and eruption of 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 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  -  Upper and Lower Braces

The goal of the second phase is to make sure each tooth is in the correct alignment and in a position of balance 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.

The second phase begins when all permanent teeth have erupted and usually requires braces on all the teeth, for an average of 20 - 24 months. Retainers are worn after Phase Two is completed, to ensure you retain your beautiful smile.

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