Woman with Braces

Two Phase Treatment

At Elara Orthodonticswe are committed to provide highest quality of dental care to our patients. We employ some of the nation’s top doctors and dental specialists in our state of art office located on Richmond .

When is a Two-Phase Treatment Necessary? A Step by Step Guide

While braces are a common rite of passage for many children and teens, some patients may require more specialized intervention. Perhaps their jaw requires help aligning or maybe their mouth isn’t growing as it should. To maximize the efficacy of orthodontic treatment options such as Invisalign or braces, patients may require something called a two-phase treatment. The goal of this treatment option is to place patients in the best position to be successful as when the complete treatment process is finished. Before deciding to go with a multi-step treatment approach, it is important for patients to understand how the process works.

Woman with Invisalign
Woman with Invisalign

The First Phase of the Treatment

Some patients may be ready to jump right to braces; however, other patients may need other specialized intervention before their mouth is ready for braces. In the first phase of the treatment, the goal is to help children, teens, and other growing patients position their jaw properly for the second phase. If the jaw is out of alignment from the rest of the face, this can lead to problems when braces or other orthodontic treatment options are applied. Therefore, it is important to get ahead of these issues and address them early. This will lead to improved treatment results.

If the upper or lower jaw are growing too quickly or too slowly, this can throw off the treatment and, possibly, lead to mechanical issues when patients try to eat or speak. If children have a jaw that is growing improperly or have a mouth that is overcrowded with teeth, they may be candidates for an early orthodontic intervention. This kind of careful planning will place patients in the proper position to find success when the second phase of treatment is started. Furthermore, records such as teeth models and x-rays during the first phase will allow the second phase’s treatment to be tailored specifically to the needs of the child.

A Break in Between

After the first phase has been completed, the mouth is allowed to rest. This will give the mouth time to recover from the first phase as it completes its growing. During this time, the permanent teeth will come in and the baby teeth will fall out. As these teeth finish coming in, a close watch will be kept on the mouth to ensure that the first phase has worked the way that is was meant to. If the baby teeth are having trouble falling out, patients may be asked to return to the office so that the teeth can be removed. This will encourage the remaining permanent teeth to come in

The Second Phase of the Treatment

Sometimes it makes sense to combine braces and Invisalign treatment for a single patient. For example, consider a situation when Invisalign can ideally treat the upper teeth, but not the lower ones. In this case, the orthodontist can make a set of aligners only for the top teeth while putting braces on the lower. This was just an example. There are many other circumstances where orthodontists may like to combine both treatment techniques. Invisalign and braces can be done simultaneously as the previous example. Or, a small (partial) set of braces can come first, and be followed by Invisalign (or vice versa). This type of combination, whatever the case may be, generally can make the treatment more efficient or more convenient for the patient.


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