Two-Phase Treatment

Orthodontic treatment is a transformative process that not only improves the aesthetic appeal of one’s smile but also addresses functional issues with bite and jaw alignment. Two-phase orthodontic treatment is a specialized process that involves a targeted approach during a child’s growth to correct issues early on and often leads to a more effective long-term outcome. It typically consists of two distinct phases, each with a specific objective in the overall treatment plan.

Phase 1

The first phase of treatment, known as Phase 1 or the interceptive phase, generally starts while the child still has most of their primary (baby) teeth and is beginning to get some of their permanent (adult) teeth. This phase is initiated around the ages of 6-10 years old and is intended to take advantage of the child’s skeletal growth to make significant corrections.

• Jaw Development — Modify jaw growth to accommodate all the permanent teeth and improve the way the upper and lower jaws fit together.
• Alignment — Address significant problems such as crowding by guiding the growth of the jaw and incoming permanent teeth.
• Functional Corrections — Correct bad oral habits and improve certain bite problems like crossbite, overbite, or underbite.
• Prevention — Prevent more severe problems later on and may reduce the need for extractions or surgery in the future.

During this phase, the orthodontist may use fixed or removable appliances to move teeth, hold space for incoming permanent teeth, or modify the jaw’s growth patterns. This treatment sets the foundation for a better overall alignment and function, making any further treatment simpler and less invasive.

Resting Period

After Phase 1 is completed, there is a resting period during which the remaining permanent teeth are allowed to erupt naturally. During this time, the progress is monitored carefully to ensure that the treatment goals are being maintained and that emerging issues can be addressed promptly.

Some key aspects of the resting period are:

• No active treatment takes place in this phase.
• Retainers may be used to retain the positions of the teeth corrected in Phase 1.
• Regular check-ups allow the orthodontist to monitor the eruption of permanent teeth and jaw growth.

This watchful waiting ensures that the timing of the second phase of treatment is optimized based on the patient’s unique development.

Phase 2

Phase 2 typically begins when most or all of the permanent teeth have erupted, usually around the age of 11 to 13. This phase involves placing braces on the permanent teeth to fine-tune their position.

The goals of Phase 2 are:

• Alignment — Ensure each tooth is located in the best position to function well with the lips, cheeks, tongue, and other teeth.
• Aesthetics — Perfect the aesthetics of the smile and facial balance.
• Function — Enhance the function of the teeth and bite, allowing for more efficient chewing, speaking, and maintenance.

This phase uses traditional braces or aligners over a period of approximately 12 to 24 months, depending on the individual’s needs. After the braces are removed, retainers are provided to maintain the new positions of the teeth.

Space Maintainers

What happens when a child loses a baby tooth too soon, and the adult tooth isn’t ready to come in just yet? Your child risks having crooked teeth. That’s because primary teeth are placeholders for adult teeth and the extra gap may cause surrounding teeth to shift. While the natural body does a great job of taking care of itself, sometimes it needs extra help. For example, when a baby tooth falls out way too soon and the permanent tooth isn’t ready to come in just yet. Fun fact: Some teeth don’t come in until the age of 12 or 13!

Premature gaps in your little one’s smile may lead to more expensive and time-consuming procedures in the future. For example, misaligned teeth in their teenage years could mean thousands of dollars in braces. So be like the tooth fairy, and keep an eye out for lost teeth!

Working with your child’s dentist, we can help prevent this from happening by determining if your child needs a space maintainer, a simple device that keeps the space open until the new tooth comes in.

Surgical Orthodontics

Surgical orthodontics, also known as orthognathic surgery, is an advanced field of dentistry that corrects severe cases of jaw bone abnormalities, malocclusions, and dental irregularities that cannot be effectively treated with braces alone. It integrates the expertise of both orthodontists and oral surgeons to achieve optimal results in functionality, health, and aesthetics.

Orthognathic surgery is typically recommended for adult patients when their jaws have stopped growing, usually by the age of 18 for males and 16 for females. Conditions that could benefit from surgical orthodontics include:

• Misaligned jaws causing difficulty in chewing, biting, or speaking
• Chronic jaw pain or TMJ (temporomandibular joint) disorders
• Protruding jaw or receding chin
• Open bite, where the upper and lower teeth do not meet
• Facial asymmetry or abnormalities caused by congenital defects or injury

The Surgical Orthodontics Process

The process of surgical orthodontics is a coordinated effort between the orthodontist and the oral surgeon and consists of several phases:

1. Pre-Surgical Orthodontic Treatment — Braces or other orthodontic appliances are used before surgery to move teeth into a new position. Even if the teeth seem worse at first, they are being positioned to fit properly after the surgery. This phase usually lasts 6-18 months.
2. Surgical Procedure — Once the teeth are properly aligned, the oral surgeon performs the surgery to correct the jaw alignment. This surgery is performed in a hospital setting and can involve one or both jaws. Common procedures include the removal of excess bone, restructuring, and realignment of the jawbone, and use of plates, screws, or wires to secure the jaw in its new position.
3. Post-Surgical Orthodontic Treatment — After a healing period, minor adjustments may be necessary to fine-tune the bite. The post-surgical orthodontic treatment could last 6 to 12 months.
4. Retention — Once the braces are removed, retainers are used to maintain the new positions of the teeth and the jaw adjustment.

Recovery time from orthognathic surgery varies from one individual to another but generally includes a two-week rest period followed by a gradual return to normal activities. Swelling and discomfort are common but can be managed with medication and care.

The results of surgical orthodontics are often life-changing. Patients can experience improved chewing, speaking, and breathing functions, relief from chronic jaw pain, and enhanced facial aesthetics. Although the journey through surgical orthodontics is complex and can be challenging, the long-term benefits contribute significantly to a patient’s quality of life and self-confidence.

Surgical orthodontics represents a significant step in the journey towards optimal oral health and aesthetics. With careful planning, expert care, and collaboration between the orthodontic and surgical teams, patients can achieve functional improvements and aesthetic outcomes that are unattainable with orthodontic treatment alone. As with all medical procedures, potential candidates should thoroughly discuss the risks, benefits, and expectations with their orthodontist and oral surgeon to make an informed decision.

Nightguards

Nightguards are a type of dental appliance that serve as a protective barrier between the upper and lower teeth. They are commonly used to prevent damage caused by bruxism, which is the medical term for grinding or clenching of the teeth during sleep. These custom-fitted devices are an essential tool in preserving dental health for individuals who suffer from this often subconscious habit.

The primary function of nightguards is to protect the teeth and reduce the wear and tear that occurs from the constant pressure and friction of tooth grinding. By creating a physical barrier, nightguards help to:

• Prevent Tooth Damage — Continuous grinding can lead to chipped, fractured, or worn-down teeth. Nightguards protect the tooth enamel by absorbing and dispersing the force of the bite.
• Reduce Jaw Strain — Bruxism often results in overworked jaw muscles, leading to pain and discomfort. A nightguard can alleviate some of this strain, promoting muscle relaxation.
• Minimize TMJ Disorders — Chronic teeth grinding can exacerbate temporomandibular joint (TMJ) issues, causing pain and dysfunction in the jaw joint. Nightguards can help to prevent or lessen these symptoms.
• Decrease Headaches And Earaches — The tension from clenching and grinding can cause headaches and refer pain to the ear area. Wearing a nightguard can reduce the frequency and intensity of these discomforts.

Retainers

Orthodontic treatment can transform a crooked smile into a perfect alignment of teeth. However, achieving that straight smile is just part of the journey. The phase that follows, known as retention, is critical to maintaining the results. This is where retainers come into play.

Retainers are custom-made orthodontic devices created from wire and/or clear plastic. They are designed to hold teeth in their new positions after braces have been removed or once aligner treatment (like Invisalign) is completed. There are two broad categories of retainers:

• Fixed Retainers — These consist of a metal wire that is permanently bonded to the backside of the front teeth. Since they are not removable by the patient, they provide continuous support to the teeth.
• Removable Retainers — These can be taken out of the mouth for eating and cleaning. They come in two main types:
  • Hawley Retainers — Made of metal wires embedded in a molded acrylic base that fits the palate or lingual area.
  • Clear Plastic Retainers — Similar to aligner trays, these fit snugly over the entire arch of teeth and are less noticeable than Hawley retainers.

A successful orthodontic treatment is a significant investment in your smile. Retainers are the key to preserving that investment and ensuring that your teeth remain straight and beautiful for a lifetime. Whether you’re wearing a fixed or removable model, your commitment to proper retainer use and care is essential in the post-orthodontic phase. Always follow your orthodontist’s advice and remember that a retainer is your partner in maintaining that perfect smile long after the braces come off.