Two Phase Orthodontic Treatment


Two phase orthodontic treatment involves the diagnosis and correction of malocclusion in two separate stages to achieve an optimal final result. The first of these phases usually begins around 8 years old, concluding in approximately 12 to 15 months. This interceptive approach is typically recommended for dental problems that will worsen with time, moderate to severe crowding, crossbites, situations that have long term health implications, or esthetic issues that may adversely affect self-esteem. A supervision period between the two phases allow Dr. Vogt and/or Ellerhorst to monitor continued growth and maintenance of the first phase result. The second phase usually begins when all of the permanent teeth have erupted, around 12 years old and can last from 12 to 30 months, depending on the occlusion and eruption of the permanent teeth. Sometimes the second phase is not necessary, but if an ideal result is desired, it is usually recommended.

First Phase: The goal of this first phase is to allow for a more stable, ideal result in the second phase or to eliminate a second phase if possible. We always strive to keep this phase as short and efficient as possible. Benefits can include:
1. Reducing the likelihood of extracting permanent teeth to alleviate crowding in the permanent dentition
2. Correcting the jaw shape and directing growth toward an ideal relationship between the upper and lower arches
3. Correcting a crossbite, leading to a more stable correction for the second phase of treatment
4. Decreasing the time necessary and complexity of the second phase
5. Improving self esteem by creating a more esthetic smile


Supervision Period: This allows for us to monitor the growth pattern and maintain the results of the first phase through the use of retainers when necessary. This can include continued use of a headgear or a lower holding arch among other appliances. It is important to note that the permanent teeth are not in their final position at the conclusion of the first phase; this is usually accomplished in the second phase.


Second Phase: This finishing phase allows for the ideal correction of esthetics and function once all of the adult teeth have erupted. Most of the time, full upper and lower braces are used to complete our mutual goals of health, function, stability, and esthetics. It is essential that retainers are worn indefinitely after treatment has been completed in order to maintain these optimal results.

Appropriate 1st Phase Treatment
1. Crossbites
2. Crowding
3. Underbite growth pattern
4. Excessive overjet
5. Impacted teeth or ecopic eruption
6. Habits (thumb sucking, tongue thrusting, etc.)
7. Space maintenance
8. Esthetics

Please feel free to discuss any questions or concerns regarding two phase treatment or any other orthodontic issues with Dr. Vogt and/or Ellerhorst at your convenience.