There seems to be a lot of confusion about why some children in Queensland start orthodontic treatment early (Phase I), only to have treatment again when all the permanent teeth have erupted (Phase II). Meanwhile, other children have orthodontic treatment only one time after all the permanent teeth have erupted (comprehensive treatment).
What is Phase I Orthodontic Treatment?
Phase I orthodontic treatment or “early treatment” is often recommended for patients ages 7-10 who will benefit from beginning orthodontic treatment prior to the loss of all their primary teeth.
Should all children have Phase I orthodontic treatment?
No, not all children. Phase I treatment is recommended for children who have moderate to severe bite problems, such as cross-bite (some of the upper teeth fitting on the inside of the lower teeth), an underbite, or an open bite. It may also be recommended for severely malaligned or crowded teeth.
An orthodontist’s goal with phase I treatment is to develop the jaw size to accommodate all the permanent teeth and relate the upper and lower jaws to each other.
Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is over-growing or under-growing can be recognised at an early age.
If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment, this will decrease the amount and complexity of treatment later, such as having to extract teeth.
Early growth guidance treatment can help coordinate this jaw growth. This early correction may prevent surgical procedures to align the upper and lower jaws.
Typically, children requiring early treatment will have a removable appliance (similar to a retainer) and/or 4-6 braces on the erupted permanent teeth. Treatment may also involve an expander if a cross-bite or severe crowding is present. Specifics of treatment will be discussed thoroughly with you and your child at the consultation.
In this phase, remaining permanent teeth are allowed to erupt. Retaining devices are not usually recommended since they may interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement until final eruption occurs.
A successful first phase will have created room for teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.
Will treatment be needed again later?
At the end of phase I 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.
Most patients will require a second phase of treatment after the rest of the permanent teeth erupt (Phase II treatment), although occasionally further treatment is not necessary.
This later treatment will be shorter and less complex than what would have otherwise been necessary. For example, the removal of permanent teeth may be avoided by having Phase I treatment.
This second phase of treatment is often just to align all the teeth into a perfect position, or “detail” the bite—with the bulk of the correction being completed in the first phase.
Timing and type of treatment are dependent upon the problem and its severity, but typically Phase I treatment will take 6-12 months and generally occurs between the ages of 7 and 10.
The eruption of the permanent teeth will usually take 12-24 months to erupt, after which your child will be ready for “final finishing” or “Phase II” treatment. This second phase of treatment can take from 12 to 24 months.
Call us on 4840 2832 for an initial consultation and we will determine the best time for treatment, outlining the treatment plan, the treatment duration and the approximate cost for the treatment.