Many orthodontists like to treat patients in two phases. The first phase begins around age 9 after the front teeth have erupted. The second phase is to complete orthodontic care after the rest of the teeth come in. All children should be seen for an orthodontic evaluation at an early age, usually between the ages of 7 and 9. In the majority of cases it is a good option to wait until all the teeth have come in before placing braces. Many early problems can be corrected with more conservative approaches including retainers, expanders and space maintainers. These can help resolve early problems without having to do two separate treatments with braces. Most parents are happy to not have to pay for braces twice and most kids prefer treatment in a single phase.

Are there advantages of two-phase orthodontic treatment?

Yes. The main reason to consider two-phase orthodontic treatment is where there is damage occurring to the teeth and early prevention is required. Also, where cosmetic problems are very severe a child is socially impacted by severe tooth problems. It is important to understand that the end result of treatment, whether done in two phases or a single phase is likely to be the same. While there is clearly a benefit in getting some of the work done early, a family should recognize that in most cases when early treatment is rendered, a second phase is typically going to be required. In most cases it is an option to wait and treat in a single phase. Severe bite problems and crossbites are examples of problems that most orthodontists agree should be treated early.

What is the alternative to two-phase orthodontic treatment?

At Columbia Orthodontics we offer a great service we call our "guidance program". The idea is to help the teeth come into the best positions possible, often with minimal to no orthodontic treatment. This is done by periodic follow-up examinations to see how the teeth are coming in. As needed, we may recommend for the dentist to remove baby teeth that are not falling out as they should or recommend space holding appliances. The "guidance program" is done as a courtesy. It is a great value. Many of our patients are seen for several years before incurring cost when it is the appropriate time to initiate braces.

Ultimately it is not necessarily to receive treatment early, but to have an orthodontic evaluation early. We want our patients to have confidence that our doctors will recommend orthodontic care at the most appropriate time for their child.