Two-Phase Orthodontics Treatment

Although certain orthodontic problems may be delayed until after baby teeth fall out, a number of problems can be best corrected when the patient is young. The focus of orthodontic treatment in Phase I is the correction of abnormal jaw growth. The advantage of early treatment is that it allows room for permanent teeth to properly emerge, which reduces the chance of needing extractions in the future. Dr. Steven Ricci offers two-phase orthodontics for young patients who visit Ricci Orthodontics.


Some confusion exists regarding the need for certain children to begin early orthodontic treatment (Phase I) but who need to have Phase II treatment after the eruption of their permanent teeth.


This process is a combination of tooth straightening and changes to the facial structure. The goal of two-phase orthodontics is to give your child the greatest opportunity to have the optimum functional, healthy, and aesthetic result for the rest of their life.

What If There Is a Delay in Treatment?

Delaying treatment may mean more invasive treatment later that may never properly correct your child’s smile. Early treatment gives your child the best chance of achieving long-lasting results.


Phase I orthodontic treatment is normally for children ages seven to ten who can benefit from early orthodontic treatment before losing their primary teeth. The goal of Phase I orthodontic treatment is to help the jaw develop so that it allows adequate room for all permanent teeth to enhance the fitting of the upper and lower jaw. Children may display signs of early jaw problems while growing and developing. For example, if the upper jaw is becoming overdeveloped or is overly narrow, an early diagnosis can take place. If the child is over six years old and has this jaw problem, they may be able to begin early corrective orthodontic treatment. If a child is around the age of eight and they have crowded front teeth, treating them early may prevent the extraction of permanent teeth years later.

Early planning may save your child’s teeth later on. Children have the greatest chance of developing a healthy, attractive smile when they receive early treatment. Early treatment can save permanent teeth later on or prevent the necessity of jaw realignment surgical procedures.

Phase I Treatment Benefits:

  • Positively influence jaw growth
  • Improve the width of dental arches
  • Correction of negative oral habits
  • Reduce or even eliminate the necessity for jaw surgery
  • Reduce the need for permanent teeth extraction
  • Enhance aesthetics and self-esteem
  • Improve development of speech
  • Guide permanent teeth to better positions
  • Shorten and simplify treatment time for Phase II

Do All Children Need Phase I Orthodontic Treatment?

Children with moderate to severe bite issues, such as an underbite, open bite, or crossbite (upper teeth nested inside lower teeth), require Phase I treatment. It may also be necessary for teeth that are severely crowded or misaligned.

One aim of Phase I orthodontic treatment is the creation of an environment that favors permanent teeth eruption. This lowers the complexity and amount of treatments required later, such as the need for tooth extractions. Phase I orthodontic treatment may include uncoordinated jaw growth pattern alterations because poor bites are often related to one jaw growing more quickly or slowly than the other jaw. Early growth guidance treatment can benefit this type of jaw growth. Early intervention may mean further procedures to align the upper and lower jaws.

Normally, patients who need early treatment will need intervention on their erupted permanent teeth that requires the use of a removable appliance similar to a retainer or dental braces. An expander may also be essential if significant crowding or a crossbite is present. We will go over treatment details with you and your child during your consultation.


During this phase, we won’t touch the remaining permanent teeth while they erupt. Retaining devices may not be a suggestion if they would interfere with eruption. Some freedom of movement for existing permanent teeth is best. If the first phase is successful, there will be room remaining for permanent teeth to erupt. If this does not occur, teeth may be impacted or severely displaced.

At the conclusion of the first treatment phase, teeth are still not resting in their final locations. This can take place during the second treatment phase. Sometimes, removing certain baby teeth may help with proper eruption during the resting phase. This means that periodic follow-up appointments may be required, typically every six months.


Patients will typically need another treatment phase after the rest of their permanent teeth erupt, although this is not always the case. Phase II orthodontic treatment is less complex and lengthy. For example, permanent teeth removal can be prevented with Phase I orthodontic treatment. Phase II treatment may simply involve the alignment of teeth into their proper positions or help with the bite because most of the needed work was accomplished during Phase I.

The type and timing of treatment depend on the severity and nature of the issue, but Phase I treatment normally takes about 6 to 18 months for children who are between seven and 10 years old. The rest of the permanent teeth typically require from 12 to 24 months until eruption, at which point the child will be ready for Phase II orthodontic treatment. Phase II can last from 12 to 24 months.


Comprehensive orthodontic treatment involves the use of traditional braces, at times in conjunction with another orthodontic device after the eruption of most permanent teeth. This occurs on average at age 12. Patients needing comprehensive treatment do not require additional stages of treatment and it normally lasts 12 to 30 months.

Patients requiring comprehensive orthodontic treatment do not have severe crowding or bite issues that necessitate early treatment. They can also be patients with severe bite issues requiring earlier intervention. In other cases, those with severe bite problems can be more easily treated when going through a growth spurt.

At Ricci Orthodontics, our team of specialists provides the dental care needed for function and aesthetics. Our services also include:

To learn more about two-phase orthodontics in Johns Creek, Georgia, and what it means for your child, contact Ricci Orthodontics at 678-417-9848 to schedule a consultation with our friendly orthodontist.