Why would Dr. Boutin recommend two-phase orthodontic treatment?
In some young patients you simply cannot wait until later to do orthodontic treatment. Some orthodontic problems like crossbites or overbites can cause tooth damage that cannot be undone later so an early first phase of treatment must be done to prevent irreversible changes. Some bite problems cause jaws to grow in unusual directions and correcting them early is a priority to prevent deformity that cannot be completely corrected later. If primary teeth are lost prematurely, other teeth drift around and you can lose space for some permanent teeth - these teeth could get stuck and become impacted. Two-phase orthodontic treatment is a specialized process that involves early interceptive treatment (Phase I) followed by more comprehensive treatment with full braces later (Phase II).
What if I put off treatment?
Putting off treatment in cases of crossbites or deep overbites can result in tooth wear/attrition that cannot be reversed. Putting off treatment in overbites can mean that there will not be enough growth left later to completely correct the bite problem. Putting off treatment in situations where an early bite problem causes the jaws to grow in unusual directions may result in a deformity that can only be corrected later with jaw surgery. Putting off treatment may result in teeth that become impacted, complicating future orthodontic treatment to the point where surgery and/or extraction of teeth may be needed. In short, putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your smile.
The goal of Phase One treatment is to help the jaw develop in a way that will accommodate all of the permanent teeth and improve the way the upper and lower jaws fit together. Children often exhibit early signs of jaw problems as they grow and develop. An upper jaw that is growing too far forward or is too narrow can be recognized at an early age. If young children are found to have this kind of jaw discrepancy, they are candidates for early orthodontic treatment. Also, if children around the age of eight have crowded front teeth, early treatment can prevent the need to extract permanent teeth later.
- Planning now can save your smile later
Receiving early treatment may prevent the removal of permanent teeth later in life, or prevent the need for surgical procedures to realign the jaws in the future.
- Making records to determine your unique treatment
Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits for the first phase of orthodontic treatment. Records consist of models of the teeth, X-rays, and photographs. During your child's initial consultation, your doctor will determine if Orthodontic Diagnostic Records are needed to plan early treatment.
Resting or Retention Period
In this phase, the teeth that have been straightened often must be held in place with retainers and the remaining permanent teeth are left alone as they erupt. Retaining devices may have to be modified or not be recommended if they would interfere with eruption of these new teeth. It may be necessary to allow the existing permanent teeth some freedom of movement. A successful first phase will have created room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.
- Monitoring your teeth's progress
At the end of the first phase of treatment, teeth positions are improved but they 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 of permanent teeth during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.
The goal of the second phase is to make sure 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. Phase Two usually involves full upper and lower braces.
At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was established. Certain types of appliances were used in the first phase to correct and realign the teeth and jaw. The second phase involves updating diagnostic orthodontic records and begins when the last baby molars are falling out, and usually requires braces on all the teeth for an average of 18 to 24 months. Retainers are worn after this phase to ensure you maintain your result.