Phase 1 orthodontic treatment is early care that some children need before all of their adult teeth have come in. It usually starts around age seven, and it exists to correct problems that get harder and more invasive to fix later on. Parents ask our team at Windy City Orthodontics about this constantly, so here is a straight answer on what phase 1 is, which kids actually need it, and what happens after.
The Full Process
Before breaking down the first portion of this treatment, let’s cover what the entire plan looks like. The need for two-phase treatment varies from patient to patient and case to case, and it is specifically for children.
- Phase One (Early Treatment or Interceptive Phase): This phase is usually between ages seven and ten, when a child still has a combination of baby teeth and permanent teeth. The goal is to address specific issues like severe crowding, crossbites, or protruding front teeth. Left alone, any of those can cause long-term damage to the permanent teeth, and all of them are easiest to correct in a growing child.
- Phase Two (Comprehensive Treatment): This happens once most or all of the baby teeth have been lost, typically around ages eleven to fourteen. It focuses on final alignment of the permanent teeth and on getting the upper and lower jaws to line up. Comprehensive treatment usually involves full braces or other appliances to fine-tune tooth and bite positions.
Why Age Seven Is the Checkpoint
The American Association of Orthodontists recommends every child have a first orthodontic evaluation by age seven. That number is not arbitrary. By seven, the first adult molars and front teeth have usually come in, which is enough for Dr. Pakravan to see how the bite is developing and whether the upper and lower jaws are growing together the way they should.
Here is the part that surprises most parents. The majority of kids who come in at seven leave with nothing but a recheck on the calendar. An early visit is not a sales pitch for braces. It is a look at whether anything needs to be caught while the bones are still soft enough to guide, and for most children the answer is no. Knowing that is worth the appointment on its own.
When something does need attention, catching it at seven or eight is usually the difference between guiding a jaw and correcting one. That is the whole argument for early evaluation.
Examining Phase One Interceptive Treatment
Let’s take a look at some of the most common reasons for phase one treatment in our youngest patients.
- Severe Crowding: Early treatment is generally recommended when there is significant crowding. Addressing it early creates more space for permanent teeth to erupt properly.
- Crossbites: A crossbite happens when the upper and lower teeth do not line up correctly. It can often be corrected by guiding the jaw’s growth, sometimes with a palatal expander, before the misalignment gets more severe.
- Protruding Front Teeth: Children with prominent front teeth benefit from treatment that addresses the protrusion and reduces the risk of injury to those teeth.
- Dental and Skeletal Discrepancies: Phase one is a good solution when there are significant differences between the size of the upper and lower jaws, or other skeletal issues.
- Habits and Other Oral Health Concerns: Problems caused by habits like thumb-sucking or tongue-thrusting can be addressed during phase one. Early treatment may also help with related issues like difficulty chewing or speaking.
- Space Maintenance: Phase one can involve appliances that hold or create space for permanent teeth, especially when there is a risk of impaction or other eruption problems.
- Improving Facial Esthetics: Addressing these issues early contributes to more balanced development of the face and profile.
- Functional Issues: Problems with chewing, speech, and jaw function may be addressed during this process.
What Comes After Phase One
Phase one sets up the mouth. Phase two finishes the job. Once the permanent teeth are mostly in, most kids move on to braces or another comprehensive appliance to bring everything into final alignment. There is usually a resting period in between, where nothing is happening except growth and periodic check-ins.
Parents sometimes hear “two phases” and assume it means twice the work. In practice, phase one often makes phase two shorter and simpler than it would have been, because the hardest structural problems are already solved.
FAQs
We totally understand that you might have further questions about this method, and we can cover some of those common inquiries here.
How long does phase one treatment last?
This varies quite a bit based on the child and the severity of what is being corrected. Typically it takes several months to a couple of years. Dr. Pakravan will give you a specific timeline after the exam rather than a generic estimate.
Are there risks or side effects associated with this manner of treatment?
As with any medical or dental procedure, there will always be minor risks and side effects. Our team gives a thorough explanation of this before starting treatment and walks through the factors that matter for success, including patient cooperation and proper appliance wear.
How often are follow-up appointments needed during this process?
Any orthodontic treatment requires regular check-ins with Dr. Pakravan. During this phase, you will typically come in every month or two so we can monitor progress, adjust appliances, and address any concerns. Being present for these appointments is essential.
Does phase one treatment avoid the need for braces later on?
Probably not. Phase one is foundational for final alignment with braces, because it conditions the child’s teeth and mouth for that stage. Using the two together is the point.
Does every child need this treatment?
No. This is always recommended based on individual needs, and the great majority of children can wait until the permanent teeth have all erupted. Some kids only need comprehensive treatment in their adolescent years. Early intervention is vital in certain cases and simply preferable in others.
Setting the Scene
We hope you have a better sense now of what phase one treatment looks like for pediatric patients, both on its own and alongside future treatment. It is a common course of treatment for a lot of kids, and our team is well-versed in it. If you have further questions, or you just want to know where your child stands, we would love to see you for a free consultation.