All About Two-Phase Treatment

Once your child has completed their orthodontic evaluation with us here at Shaw Orthodontics, you may hear us mention something called “two-phase treatment.” If you’ve never heard this term before, it can seem a little bit intimidating!

It’s a lot less complicated than it sounds, however. Basically, two-phase treatment is just an orthodontic process carried out in two stages, encompassing tooth straightening and physical, facial changes. The biggest advantage with this type of treatment is that it allows us to maximize the opportunity to provide to our patients a healthy, functional, and attractive result that will remain stable for years to come.

What two-phase treatment is not is a tricky way for us to get you into two sets of braces. It won’t cost double the money or take double the time. While we prefer to avoid two-phase treatment whenever possible, some cases will require this process to bring about the best results.

The first phase, or Phase 1, is what we call interceptive orthodontic treatment. True to its name, it can intercept many orthodontic problems in their early stages to help prevent them from developing into more severe dental problems over time.  This type of treatment usually occurs at an age when the permanent front teeth are erupting, around 8-9 years old. We encourage interceptive treatment for cases in which further delay may cause serious orthodontic problems, or even worsen social difficulties a child may be experiencing due to crooked or misaligned teeth and jaws.

The second phase, or Phase II, will be employed only after the eruption of all permanent teeth. Phase II is administered to achieve the perfect alignment of teeth in patients, which just isn’t possible when baby teeth are still present.

Still unsure about what it all means? Confused by the shop talk? Let’s take a deeper look to help you understand!

Phase I orthodontic treatment

Phase I orthodontic treatment is typically the first of two phases of treatment. When a young patient needs intervention before starting regular orthodontic treatment, it results in two separate treatment phases. A Phase I treatment plan can include orthodontic appliances, retainer-like devices, or partial braces. These are used to prevent potential problems, correct current problems, and to help modify a child’s growth and dental development.

This interceptive treatment begins at an early age, usually between the ages of 6-10 years. These patients will usually still have both baby teeth and permanent teeth present. Phase I treatment is usually only recommended if there is a dental developmental issue or dental or jaw development problems that could become more severe if left untreated over time. Though not all children will need to have early treatment, for those who do, it can come with many benefits. This is why Shaw Orthodontics, as well as the American Association of Orthodontists, recommend children having their first orthodontic evaluation by the age of seven. An early consultation with an experienced orthodontist like Dr. Shaw is the best way to ensure a child’s growth and dental development are optimal.

There are a number of dental issues that can be corrected with phase I treatment, such as tooth alignment, crowding and spacing issues, gum or periodontal health, and the development of the jaws. Some of the more common reasons orthodontists will recommend phase I treatment include:

  • dental crossbites
  • skeletal crossbites
  • underbites
  • excessively overlapping or deep bites
  • open bites (where the teeth in the front do not contact or overlap)
  • jaw growth or jaws that are not in proportion to each other
  • severely protruding teeth
  • the presence of problematic oral habits, such as extended thumb-sucking, bottle, or pacifier use
  • clefts
  • severe crowding or spacing of the teeth

Although it isn’t always necessary, often a second phase of treatment will need to follow the first. Because of the early intervention provided by the first phase of treatment, this second phase doesn’t normally last as long as the initial one. Early treatment can often turn severe problems into a simpler issue that can likely be treated with braces or other orthodontics at a later date.

The resting period

By the end of the first phase of treatment, the teeth won’t yet be in their final positions. This is accomplished during the second phase of treatment. In between the two phases, we allow for a period of rest, during which time the remaining permanent teeth are allowed to come in.

Phase II orthodontic treatment

Phase II treatment is the more familiar types of orthodontic treatment that may need to follow early interceptive treatment. This will often consist of placing braces on both the upper and lower teeth once all the adult teeth have come in. Since Phase I treatment can’t always guarantee correcting all the tooth and bite-related problems a patient may have, this second phase of treatment with braces may be needed to finish aligning the teeth and bite. During this phase, a trained orthodontist like Dr. Shaw will straighten the permanent teeth and finish correctly aligning the patient’s jaws into the proper bite.

The goal of the second phase is to make sure each tooth has an exact, optimal location in the mouth where it can coexist peacefully with the lips, cheeks, tongue, and other teeth. Once orthodontics allow this state of equilibrium to be established, the teeth will finally be able to function together properly.


The first phase of two-phase treatment will include an orthodontic evaluation, diagnosis, and a specialized treatment plan. There may be appliances involved, depending on the severity of the patient’s problem. The second phase occurs only after all the permanent teeth have erupted, and will usually consist of braces being placed on all the teeth. After both of these phases of treatment have been successfully completed, retainers will be recommended to help keep teeth in their newfound positions and maintain a beautiful, straight, and healthy smile.

Taking on two-phase treatment with Shaw Orthodontics

Two-phase treatment won’t be recommended for every child, but it’s worth remembering that putting off this kind of indicated treatment for a child can result in far more invasive treatment later in life. Early treatment is always the most effective plan for achieving lasting results!

If you’re in Rockwall or the surrounding area and have a young child under the age of seven who hasn’t yet seen an orthodontist, get in touch with us today or click here to schedule an initial orthodontic evaluation at our conveniently located office. Using state-of-the-art treatment techniques and equipment, our friendly, experienced team have what it takes to craft a smile that will last from childhood into adulthood and beyond.

Give us a call to see what we can offer you and your family!