Dr. Tsibel prioritizes appropriate two-phase orthodontic treatment over unnecessary over-treatment.
The American Association of Orthodontists (AAO) recommends orthodontic screenings for children at age 7. Dr. Tsibel supports this recommendation, understanding that some orthodontic issues are best addressed in two phases. When necessary and appropriate, two-phase treatment can yield amazing results.
However, recent research shows that some early orthodontic issues, though they may appear severe, can be effectively treated in a single stage around age 12 when all permanent teeth have erupted.
Unfortunately, some orthodontists perform unnecessary first-phase treatments, leading to more appointments, higher costs, and no better outcome than a well-timed single-phase treatment. During your consultation, Dr. Tsibel will discuss which orthodontic problems should be treated in two phases and which can be delayed until all permanent teeth erupt. In our practice, we recommend two-phase treatment for younger patients about 30% of the time.
Phase I
Phase I, or early interceptive treatment, involves limited orthodontic intervention before all permanent teeth have erupted. It typically occurs between ages 6 and 10 and lasts 9 to 12 months. Phase I treatment is recommended for severe crowding, crossbites, significant overbites or underbites, premature loss of baby teeth, abnormal tooth eruption, or harmful oral habits. This phase focuses on creating space for developing teeth, developing dental arches, widening jaws, and stimulating or modifying jaw growth. Phase I establishes a solid foundation for erupting permanent teeth, avoiding the need for extractions, complex treatments, or jaw surgery in the future.
Resting Period
After Phase I, a resting period allows the remaining permanent teeth to erupt. Retainers may initially be used but may be discontinued if they interfere with tooth eruption. Allowing the teeth some freedom of movement during this phase is beneficial.
Phase II
Phase II treatment involves full braces when all permanent teeth, including the 12-year molars, have erupted. Typically occurring between ages 11 and 13, Phase II is the final stage and lasts an average of 24 months. This phase aligns the permanent teeth into their ideal positions, enhancing aesthetics and function. The result is a beautiful, straight smile and a healthy bite.
DELAYING PHASE I TREATMENT
Delaying Phase I treatment when it is highly beneficial can lead to the following:
- Complex, extensive, and prolonged single-phase treatment
- Possible need for permanent tooth extractions or jaw surgery
- Compromised final results with long-term stability concerns
