The goal of first phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaw to each other.
Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is growing too much or not enough can be recognized at an early orthodontic appointment.
Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. Thus, a good foundation can be established, providing adequate room for eruption of all permanent teeth. This early correction most often prevents later removal of permanent teeth to correct overcrowding and/or surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with braces.
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, digital 3-D imaging, and photographs.
At the end of first phase treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.
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. They will stay healthy and look attractive. This is the goal for the second phase of treatment.
At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment planned established. Certain types of appliances were used in the first phase, as dictated by the problem. The second phase is initiated when all permanent teeth have erupted, and usually requires braces on all the teeth. There will be a separate fee for this finishing (second) phase. Retainers are worn after this phase.
Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and physical facial changes. The emphasis today on living longer, staying healthy and looking attractive requites optimum treatment results. The major advantage of a two-phase treatment is to provide the opportunity to accomplish an ideal, healthy, functional, esthetic result that will remain stable.
The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment, for someone with crowding or a jaw discrepancy, is having to face the possibility of a compromised result that may not be completely functional or healthy and may not remain stable.