Two phase orthodontic treatment is typically recommended about 25% of the time by an orthodontic specialist like Dr. James Kelley or Dr. Roberta Gardner. There are many benefits to this treatment plan, but the need to treat in two phases often comes with many questions. Dr. Kelley or Dr. Gardner will review all details with you at your complimentary initial consultation, but read below for more information.

What is 2 Phase Treatment and Why Does it Matter?

The American Association of Orthodontists recommends that children see an orthodontic specialist at age seven for an evaluation and to see if they need phased treatment. Like the name suggests, two phase orthodontic treatment has two parts – meaning the patient has braces (or another appliance) twice. While treating in two phases does increase the overall cost by approximately 25% (no, it is not doubled!) over one phase treatment, the benefits can be immense in growth and development, function, esthetics, and normal eruption of the teeth.

Two Phased Treatment timeline

What is Phase 1?

Phase 1, also called early interceptive treatment, includes expansion, partial braces, habit appliances, or any other orthodontic treatment completed before all of the permanent teeth have erupted. Children with moderate to severe bite problems and habits are more likely to be candidates for Phase I treatment.

The most common types of problems that are addressed in Phase I are: 1) a crossbite (the upper back teeth cross the lower teeth at any point of the bite); 2) an underbite (the upper front teeth sit behind the lower teeth), 3) an open bite (the upper and lower teeth are unable to close properly) caused by a habit, such as a finger sucking habit or tongue thrust; 4) severely protruded teeth (top teeth that stick out and could be at risk of trauma); and 5) severe crowding caused by early loss of a primary (baby) tooth. Phase 1 treatment usually lasts 9-12 months and the goals are very limited and specific.

What is the Resting Period?

Following Phase 1, the patient usually wears a retainer at night during a “Resting” period.  This resting period can last several years while the remaining teeth erupt. Dr. Kelley or Dr. Gardner will have the patient come in for check ups every six months during the resting period to make sure the remaining teeth are erupting normally and so everyone is prepared to begin Phase 2 at the optimal time.

What is Phase 2?

Once most (or all) of the permanent teeth have erupted, usually around ages 12-14, the patient is ready for Phase 2. The early treatment from Phase 1 was to address some very specific and limited concerns, and Phase 2 is when the bite is fully corrected and the final alignment of the teeth is established. Most patients who have Phase 1 treatment do require Phase 2. This treatment could involve full upper and lower braces or Invisalign® clear aligners. The treatment options and plans will be covered by Dr. Kelley or Dr. Gardner before Phase 2 begins. It is important to note that each phase of treatment is quoted and billed separately, which allows the needs in the second phase of treatment to be accurately evaluated before a price is determined. Phase 2 typically lasts around 18 months and is followed by retention.

What is Retention?

Even though braces or Invisalign may be removed, that does not mean that the orthodontic journey is completely over! “Retention” involves wearing retainers as instructed by Dr. Kelley or Dr. Gardner to maintain the bite and final positions of the teeth. Teeth naturally want to shift over time, and retainers are the key to maintaining a great result! After treatment is complete, Kelley & Gardner Orthodontics will continue to monitor the alignment and bite with retainer checks.  We want you to continue to embrace your smile!