Early Orthodontic Treatment/Two-Phase Orthodontic Treatment

Phase One: A Foundation for a Lifetime of Beneficial Smiles

Early orthodontics, which is also called Phase One or Interceptive Orthodontics, is the orthodontic treatment of a child who has baby (primary) and permanent teeth present. During this time, usually between the ages of 6 and 10 years old, there is a window of opportunity to make skeletal changes which can have a significant benefit in the patients' facial growth, position (straightness) of the teeth and health of the gums. This window, if missed, may result in less than optimal orthodontic results when treated later as a teen. The reason is, the bones of the upper and lower jaws are very malleable (soft) during this 6 to 10 y.o. interval. When manipulated properly, they can be shaped for the best esthetics and health of the smile. Since the changes made are skeletal the stability of the results are enhanced. 

One example is crowded teeth. We used to think that the child would "grow out of it." We now know this won't happen. A child has all the room for teeth they will ever have by the time the first permanent molars come in (around 7 y.o.). So if we see the child's teeth are crowded at 7 y.o. we know they will be crowded as they get older. If we want straight teeth and they are crowded then we have 2 options:

  1. Take out (extract) baby teeth now. This will accommodate the teeth coming in now at the expense of teeth coming in later, "Robbing Peter to Pay Paul". Later, permanent teeth are taken out (usually 4) and braces are used to straighten the remaining teeth.
  2. Expand the jaw(s) (upper and or lower) in the 6 to 10 y.o. range to make room for all the teeth so pulling teeth is not necessary. Because the jaws are malleable the expansion that occurs is skeletal which has the benefits noted above. When expansion is done after 10 y.o. the result is dental expansion. With skeletal expansion the jaws are widened, with dental expansion the jaws are not widened, the teeth are pushed out which is not esthetic, healthy or stable.

As a result of doing this Phase One treatment, then when braces are needed after all the permanent teeth are in, the treatment is much shorter and the results better!

The course of treatment is usually 6 to 12 months of Phase One treatment followed by a resting period while the remaining permanent teeth come in. The child is seen every 6-8 weeks during treatment and every 6-12 months during the resting period to check growth.

Phase Two Treatment

When all the permanent teeth are close to being in or are in (12-13 y.o.), then an evaluation for a Phase Two treatment occurs. This treatment involves complete braces for 12-20 months to finalize tooth alignment and fit. The results achieved by a two stage treatment when indicated, cannot be duplicated with one long treatment as a teenager. 

If your child is 7 y.o. then an evaluation by an Orthodontist is recommended by the American Association of Orthodontists. They might not need any treatment but better safe than sorry.  If you have any questions, please do not hesitate to contact us.  At Elite Smiles Chastain we aim to "Build a Better Smile!"


How to tell if your child may need early orthodontic treatment:

  • Early or late loss of baby teeth (your child should typically start losing teeth around age five, and will have all permanent teeth around age 13)
  • Difficulty chewing and/or biting
  • Mouth breathing
  • Your child continues sucking his or her thumb after age five
  • Speech impediments
  • Protruding teeth (the top teeth and the bottom teeth extend away from each other)
  • Teeth that don't come together in a normal manner or even at all
  • Shifting of the jaw when your child opens or closes his or her mouth (crossbites)
  • Crowded front teeth around age seven or eight

Advantages of Early Treatment at Elite Smiles Chastain:

  • All appliances are custom fit for comfort.
  • Precise diagnosis using the latest 3D technology combined with the experience of more than 15,000 smiling faces treated.
  • Your child will be seen by Dr. Sebastian at each appointment.
  • Elite Smiles Chastain uses only fixed appliances, so there is nothing removable to lose.
  • Dr. Sebastian will make all adjustments at the office, nothing for you to turn or adjust at home.
  • Most early treatments are 6 to 10 months in length with no braces necessary
  • Early treatment is designed to make skeletal changes which are the cause of most issues we treat (For example, crowded teeth are caused by small jaws not too many teeth)
  • Airway enhancement-If proper appliances are used, the upper airway can be enlarged for better breathing. Reference Sleep Disorder Breathing on our home page.