What is Two-Phase Orthodontic Treatment?

When it comes to kids, they are either growing out of things like their clothes and shoes, or they are growing into things like their feet and ears. Knowing all about how kids’ facial bones and teeth grow, our expert team at Raleigh Orthodontics also knows that some problems that will eventually need orthodontic attention can become obvious long before your child has all of their permanent teeth. These problems will only worsen over time if left untreated.

Orthodontic treatment is most commonly thought of for teens who have lost all their baby teeth or adults looking to correct their smiles later in life. But orthodontics focuses on treating the irregularities in the teeth and jaws and is not entirely relevant to the patient’s age. In fact, starting adjustments while the patient’s bones in their jaw and face are still growing can make it easier to achieve their possible smile results with less-invasive or time-consuming treatments later. 

What is Two-Phase Treatment?

Two-phase treatment is the specialized process of combining physical facial changes with tooth straightening to create one plan for your child’s optimal results. Patients who utilize two-phase treatment can avoid more arduous adjustment needs and enjoy a more stable smile and bite alignment throughout their life. 

The primary goal of two-phase treatment is to help the jaws develop while ensuring adequate space for all permanent teeth, including the permanent canines, and any alignments or adjustments necessary for a functional and aesthetic smile. Some of the benefits include:

  • Reducing the need to pull permanent teeth in the future
  • Utilizing non-invasive treatments while young to avoid corrective surgery after growth stops
  • Intervention for prolonged thumb- or pacifier-sucking, or abnormal swallowing
  • Aligning the upper and lower jaws, commonly in cases of an underbite
  • Reducing the risk of breaking or knocking out protruding front teeth

Who Benefits from Two-Phase Treatment?

Most orthodontic problems can be treated in one phase of comprehensive treatment, but some exceptions exist. If your child’s orthodontic issue doesn’t seem to improve, they may need early intervention to correct it and prevent future problems. Children with tooth damage during formation or growth, children with a narrow palate, those with snoring or mouth-breathing problems, and even an unusual or crowded bite can benefit from Two-Phase treatment. 

By the age of 7, children have a decent mix of primary and permanent teeth. This assortment of growth stages provides your child’s orthodontist with a before and after map of your child’s jaw growth and the path the emerging teeth will likely take as they grow. While there is no exact age, it is around this age that the American Association of Orthodontics recommends scheduling your child’s first orthodontic examination. 

Phase One

In Phase One of Two-Phase treatment, the primary focus is on promoting stable jaw development and ensuring space for permanent teeth. There are three main elements to Phase One treatment.

Establishing the Orthodontic Record

To get started with early orthodontic treatment, our orthodontists will create detailed records of your child’s current alignment through photos, x-rays, and models of their teeth to get started with early orthodontic treatment. This information is used to decide the best treatment path for your child’s goals. It will determine what kind of extractions or appliances will be needed, the length of time for wearing the devices, and the number of orthodontic visits they will likely need to complete their treatment. 

If treatment is not currently necessary, our Raleigh Orthodontics team will suggest routine monitoring to ensure the jaws and teeth remain in optimal positions as they grow.


Tooth extraction may be necessary for children with overly crowded teeth or remove stubborn baby teeth and allow the permanent teeth to erupt into their intended positions.

Orthodontic Appliances and Devices

Some children may need to wear an appliance or device to help encourage the movement of the teeth or jawbone and provide adequate space for adult teeth to erupt. A tongue-retaining device is used for training and positioning intervention for children who have a habit of finger- or thumb-sucking. At the same time, a palate expander can be utilized to help widen the jaw and correct breathing problems and lack of space for tooth growth. 

The amount of time your child will need these appliances will depend on the severity of their orthodontic issues and their growth. Typically, phase one appliances are worn for short periods of time.

What is Two-Phase Orthodontic Treatment?

Resting Period

After your child has completed their Phase One treatment, or if our orthodontists have determined they do not need early intervention, they will start the Resting Period of their treatment. During this portion of the process, the remaining permanent teeth are left alone while they complete their growth, and your child will be monitored by our Raleigh Orthodontics team every six months until they are ready to begin Phase Two of their orthodontic treatment. With a successful first phase, there will be plenty of room for permanent teeth to find an eruption path, and your child can avoid impaction and severe displacement that requires more in-depth treatment later. 

Phase Two

This part of the Two-Phase treatment is the most recognizable process of orthodontics. This phase will incorporate treatments that ensure each tooth is in superior alignment creating the perfect bite and smile for your child. Our skilled team will also fine-tune anything that may have changed during the resting phase of treatment. 

Phase Two Treatment Options

Metal braces may have been the only option in the past when it came to straightening your teeth with orthodontics, but Raleigh Orthodontics is excited to offer you innovative new options that fit every lifestyle and need.

Metal Braces

Modern metal braces are smaller, more comfortable, and more attractive than ever before. Metal brackets are bonded to the front of your teeth and an archwire is secured with elastic bands to create the pressure and tension that moves your teeth where Dr. Grossman wants them to go.

Clear Ceramic Braces

Clear braces are a popular choice for adults and older teens. It uses the same concept as metal braces but swaps the metal brackets for clear, ceramic brackets that make your orthodontic treatment inconspicuous.

Invisalign Clear Aligners

Clear aligners work by gradually and gently shifting your teeth into place using a series of clear, plastic aligners based on your orthodontist’s exact planned movements—no metal brackets to attach, no metal wires to tighten. 

What is Two-Phase Orthodontic Treatment?

One Phase or Two, Raleigh Orthodontics has you covered!

Your children are growing fast, and so are their teeth and jaws. With Raleigh Orthodontics and early intervention with Two-Phase Treatment, we create a plan that lays a solid foundation for a lifetime of good oral health. Your child will grow into their perfect smile while enjoying every minute of any treatment they may need along the way. Get in touch today to schedule a FREE consultation and start your child’s orthodontic records and get a personalized plan and an all-around great experience.