Two-Phase Treatment

What is the advantage of two-phase orthodontic treatment?

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

What if treatment is put off?

Putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your child's smile. Early treatment is most effective for achieving lasting results.

Phase One

A Foundation for a Lifetime of Beautiful Smiles

The goal of Phase One treatment is to help the jaw develop in a way that will accommodate all of the permanent teeth and improve the way the upper and lower jaws fit together. Children often exhibit early signs of jaw problems as they grow and develop. An upper jaw that is growing too much or is too narrow can be recognized at an early age. If children over the age of six are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Also, if children around the age of eight have crowded front teeth, early treatment can prevent the need to extract permanent teeth later.

  • Planning now can save your child's smile later

    Children benefit tremendously from early-phase treatment. Receiving early treatment may prevent the removal of permanent teeth later in life, or the need for surgical procedures to realign the jaws.

  • Taking records to determine your child's 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 scanning the teeth, X-rays, and photographs. Dr. Zoka will take records to determine if early treatment is necessary.

Resting Period

In this phase, the remaining permanent teeth are left alone as they erupt. Retaining devices may not be recommended if they would interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement. A successful first phase will have created room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.

  • Monitoring the teeth's progress

    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-month basis.

Phase Two

Stay healthy and look attractive

The goal of the second phase 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. Phase Two usually involves full upper and lower braces.

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was established. Certain types of appliances were used in the first phase to correct and realign the teeth and jaw. The second phase begins when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure your child retains his or her beautiful smile.

End of Phase Two Retainer Instructions

Congratulations! You did it! We are proud of you!

Now we have to work together to stabilize the results of the treatment period. The tongue, lips, and supporting structures must adapt to the new position of your teeth. You will need to wear retainers to protect your smile. Retainers prevent the teeth from moving back to their original position. 

About 90% of the correction can be retained. The teeth will not stay exactly where we have placed them. This readjustment is not a failure of correction, but a natural change that we have leamed to accept. 

My 100% guarantee to you is that if you don't wear your retainers your teeth will move! Only you can keep your teeth straight from this point on, if you choose to discontinue wearing your retainers, you must assume responsibility for any tooth movement. If your teeth shift, the only way to re-straighten them would be through retreatment and additional expense. 

5 Rules:

  1. Wear your retainers all day, all night until I stop you. I will tell you when you may reduce wearing time.
  2. Take them out to eat, and always place them in your retainer box. Don't leave them lying around or wrapped in tissue. It could get lost or thrown away.
  3. Keep them clean by brushing them with toothpaste and cold water. Never leave them in hot water or near a hot surface, it could change the material and make them not fit anymore.
  4. Do not chew gum with them in, it sticks to the acrylic.
  5. Bring them to every appointment. 


Your retainers should fit comfortably and securely. If they don't let us know. They won't be broken or lost if they are worn correctly. Remember they are delicate and expensive to repair or replace. Retainers are like eyeglasses, contact lenses, or any other personal items that are worn daily, they will wear out. There will be a charge to replace worn-out retainers. 

A Final Word

I hope you are proud of the way your teeth look, I am. A copy of your final X-rays will be sent to your dentist, please have your dentist clean and examine your teeth as soon as possible.

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