Two Phase Treatment

What is the advantage of two-phase orthodontic treatment?

Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and physical, facial changes. The major advantage of a two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, aesthetic result that will remain stable throughout your life.

What if I put off treatment?

Putting off early treatment may result in much more difficult treatment later on in life, including more invasive treatment and increased possibility of a compromised result.

First Phase Treatment: Your foundation for a lifetime of beautiful teeth

The goal of first phase treatment is to develop the jaw size in order to establish the proper relationship of the upper and lower jaws to one another and to guide the eruption of the permanent teeth. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment.

Planning now can save your smile later

Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. Thus, a good foundation can be established, in some cases, providing adequate room for eruption of all permanent teeth. This early correction may prevent later removal of permanent teeth to correct overcrowding and/or surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with braces.

Making records to determine your unique treatment

Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits. Records consist of digital models, x-rays, and photographs.

Resting Period

Following the first phase of treatment, patients are often placed in a resting phase, when the remaining permanent teeth are allowed to erupt. Retainers are sometimes used during this resting phase of treatment. During this time the patient’s growth and development is monitored closely, until it is determined if and when a second phase of orthodontic treatment is necessary.

Monitoring your teeth’s progress

In other words, at the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six to twelve month basis.

Second Phase Treatment: Stay healthy and look attractive

The goal of the second phase treatment is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly. Second phase treatment usually involves fixed braces or Invisalign and typically begins when all of the permanent teeth have erupted.


The retention phase of treatment is very important to maintain your orthodontic correction and beautiful smile. If retainers are not worn as directed, there is a higher chance that the teeth can “relapse” or move. Dr. Nakisher and her team will instruct you on proper retainer wear when your braces are removed.