When Are Two Phases of Treatment Necessary? - Dr. Jerome Baruffi

Usually patients we refer for orthodontic treatment already have their permanent teeth – but in some cases we recommend starting treatment earlier, even before the patient’s permanent teeth come in. We call this “two-phase treatment.”

When we have patients with clear developmental problems at an early age, it’s best to start work when they are young, before the problems get bigger and more difficult to treat. Examples include an upper or lower jaw that is not growing correctly, or a mouth growing in a way that doesn’t leave enough room for all the permanent teeth to come in.

In these cases we will refer you to an orthodontist early and do one round of treatment – phase one – while the patient still has “baby teeth.” Phase one usually does not involve braces, but can include a different type of appliance that helps the jaw grow into place properly, such as a retainer. We’ll follow up with phase two usually a few years later, when the patient’s permanent teeth have come in. Phase two often does involve braces and sometimes headgear.

In order to catch early problems, we recommend that children have an orthodontic check-up no later than age seven (and so does the American Association of Orthodontics). However, if we or your pediatrician see any sign that early treatment might be necessary, we may recommend your child visit an orthodontist even sooner.