Providence Pediatric Dentistry and Orthodontics

Two Phase Orthodontic Treatment

Phase 2 ortho treatment - Providence Pediatric Dentistry and Orthodontics logo

At your child’s consultation, the orthodontist might recommend “two phases of treatment”. This phrase may sound a bit overkill, but it’s a lot less complex than it sounds, and it may benefit your child. Here is why:

Two-phase treatment is exactly as it sounds: orthodontic treatment that is delivered in two phases. The second phase focuses on a larger subset of orthodontic issues that include: deep overbite, crowding, spacing, and maximizing facial esthetics. In children that are experiencing orthodontic issues at a younger pre-pubescent age, sometimes early intervention via a two-phase approach will give the patient the best chance at a healthy, fully functional, stable smile for many years to come. Two-phase treatment isn’t recommended for every child, but for those who need it, it can prevent the need for more invasive treatment later on in life.

Phase I Orthodontic Treatment

The first phase focuses on several larger goals that typically involve creating space for adult teeth to erupt properly and setting growth and development of the facial bones on the right path. They can involve wearing braces on upper and/or lower teeth to align teeth, a palatal expander to widen the upper jaw, and space maintainers to prevent loss of space. This interceptive phase typically happens between the age of 7 and 10, and although recommended sparingly, is used to treat dental or skeletal development problems that would get worse if left untreated.

The American Association of Orthodontists and Dr. Adam both recommend that every child be seen by an orthodontist by the age of 7 to detect any potential dental or skeletal developmental issues. Typically there is a break of anywhere from 1 to 4 years after phase I before the patient would likely (but not always) need a second phase of treatment.

Resting/Observation Period

At the conclusion of the first phase of treatment, teeth will not be in their final positions as that will happen in the second phase of treatment. Between the two phases, we take a period of rest to allow all remaining permanent teeth to come in. During this time, we’ll want to see your child every 6-12 months to observe their growth and development, as well as the eruption of the remaining adult teeth.

Phase II Orthodontic Treatment

Most people are somewhat familiar with what the types of treatment that take place during the second phase of treatment. It often involves placement of braces on all upper and lower teeth, or full Invisalign. Not all tooth and bite related issues can be corrected during phase I treatment. During the 2nd phase of treatment, a skilled orthodontist like Dr. Adam can correctly align the teeth, correctly move the jaws into the correct relationship, and maximize facial esthetics for lifelong stable results.

Phase II is typically initiated when all, or almost all, of the permanent dentition (including 12 year molars) have erupted and shortly before the peak pubertal growth spurt takes place. For girls, this is usually between the ages of 11 and 13, and for boys this is more often between the ages of 12 and 14.


After completion of both phases of treatment, removable clear retainers and sometimes “permanent” bonded retainers are recommended to maintain and protect your beautiful, new smile! If you have a child that is under the age of 7 and has not seen an orthodontist yet, please give us a call to get your child scheduled for a complimentary consultation! Our friendly, experienced team is excited to create a smile that will last from childhood to adulthood and beyond!