Phase I and Phase II Ortho Treatment
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Phase I and Phase II Ortho Treatment
I'm not actually a parent, I'm a 29 year old who just got braces for the first time even though dentists had told me since I was 9 that I needed them. Anyway, I was wondering what thoughts anyone has on Phase I and II ortho treatment for kids, with them usually having to get braces twice. Nearly all of my friends got braces as teenagers, just the one time, and got them off right before senior pictures in high school. So, I'm wondering if the Phase I and II treatment really prevents serious problems or if it's better to wait until kids have their permanent teeth and get braces a little older, like my friends did. If kids have to wear braces twice, how can you be sure that having them the first time really did all that much good? And how can parents afford to get their kids braces two times before they're 18? I'm just curious. Any opinions welcome.
As with all Ortho paitients, each persons case is different. Keep in mind that Phase I treatment does not always mean a full set of braces, it very often is accomplished with various different appliances.
My 13 year old son did not need Phase I treatment and just went into comprehensive treatment when it was appropiate for him to do it. My 9 year old is in Phase I treatment because his top front teeth, both primary and permenant came in in a way that caused his bottom front teeth to be in a very bad position. One lower tooth was being pushed so far out that it was actually breaking through the gum.
Now, for Phase I treatment my son has just the top and bottom first six teeth bracketed to achieve correct alignment for these teeth. This does include some peimary teeth with brackets. After Phase I treatment he will be monitored to see whether he needs Phase II or not, although his case will likely require Phase II treatment. That assumtion is how the Ortho based his fee for Phase I treatment. I will not say what the cost is, but rest assured that he has made it very easy for me to agree to this treatment, while ensuring that I will fully agree to the cost of Phase II treatment.
My 13 year old son did not need Phase I treatment and just went into comprehensive treatment when it was appropiate for him to do it. My 9 year old is in Phase I treatment because his top front teeth, both primary and permenant came in in a way that caused his bottom front teeth to be in a very bad position. One lower tooth was being pushed so far out that it was actually breaking through the gum.
Now, for Phase I treatment my son has just the top and bottom first six teeth bracketed to achieve correct alignment for these teeth. This does include some peimary teeth with brackets. After Phase I treatment he will be monitored to see whether he needs Phase II or not, although his case will likely require Phase II treatment. That assumtion is how the Ortho based his fee for Phase I treatment. I will not say what the cost is, but rest assured that he has made it very easy for me to agree to this treatment, while ensuring that I will fully agree to the cost of Phase II treatment.
Hi, here is my two cents since I'm in two categories, treatment and also a parent of a child who will need it. When I was a kid, I wanted braces SO BAD. I actually NEEDED them, it wasn't some misplaced 'i want it because my friends do' kind of thing. Despite not suffering cavities or bleeding gums or anything as a result, my teeth were really crooked and bad looking, and either i look horrid in pictures because I smiled, or I didn't smile. It was a big issue for me for many years. The older kids escaped braces because both of them had fairly straight teeth, no tmj issues, and no bite issues. We probably should have gotten the oldest one braces but she was kinda meh about it when we were discussing it when she was 13. She's almost 21 now and she has never said anything about being unhappy with her teeth.
I already know the little one will need braces, and I think based on how I felt, two phase treatment is great, if it's affordable. The thing with phase one is that they do things like guided eruption (like serial extraction so there's room for the front teeth to come in without getting twisted and crowded and out of the arch) and sometimes use appliances to keep them growing in right, or expansion to get rid of crossbites in the back and/or front. Those are two things I can already see going on with my daughter, and even if she ends up having to have more treatment later, I'd rather do anything to get her teeth to come in as straight and healthy as they can NOW so it's less complicated later. There may only be a year of treatment later correcting small things if you make sure things go as smoothly as possible earlier, instead of just letting teeth come in all willy nilly and think - oh, when they are 14 or 15 they can just have braces then. Then your child has suffered 8 years or so of crooked or crowded or otherwise non attractive teeth and maybe also had to have dental work because they can't brush and floss well.
From what the ortho told me, phase one is usually pretty inexpensive, like if I have to take my daughter to get some extractions, we will go to her dentist and he will do them, and if they have to make her an appliance to help guide her erupting teeth, it won't be very expensive and likely will be either some sort of bonded wire or something removable she wears at night and part of the day. The bulk of the expense is usually phase two, where you get the whole bonded brackets part. Sometimes they use bonded brackets for phase one too, but that's usually just the front 4 teeth upper and lower, sometimes 6, to straighten or make sure there's room for unerupted permanent teeth.
If you ask me, I'd rather have fairly straight teeth at 8 or 9 because of phase one and still have to have a year of braces at 14 or 15 than have messed up teeth from 7-15 and then have 2 1/2 years of braces once lol. Not everybody will feel that way but I do, and I want to make treatment as easy for my daughter as I can.
I already know the little one will need braces, and I think based on how I felt, two phase treatment is great, if it's affordable. The thing with phase one is that they do things like guided eruption (like serial extraction so there's room for the front teeth to come in without getting twisted and crowded and out of the arch) and sometimes use appliances to keep them growing in right, or expansion to get rid of crossbites in the back and/or front. Those are two things I can already see going on with my daughter, and even if she ends up having to have more treatment later, I'd rather do anything to get her teeth to come in as straight and healthy as they can NOW so it's less complicated later. There may only be a year of treatment later correcting small things if you make sure things go as smoothly as possible earlier, instead of just letting teeth come in all willy nilly and think - oh, when they are 14 or 15 they can just have braces then. Then your child has suffered 8 years or so of crooked or crowded or otherwise non attractive teeth and maybe also had to have dental work because they can't brush and floss well.
From what the ortho told me, phase one is usually pretty inexpensive, like if I have to take my daughter to get some extractions, we will go to her dentist and he will do them, and if they have to make her an appliance to help guide her erupting teeth, it won't be very expensive and likely will be either some sort of bonded wire or something removable she wears at night and part of the day. The bulk of the expense is usually phase two, where you get the whole bonded brackets part. Sometimes they use bonded brackets for phase one too, but that's usually just the front 4 teeth upper and lower, sometimes 6, to straighten or make sure there's room for unerupted permanent teeth.
If you ask me, I'd rather have fairly straight teeth at 8 or 9 because of phase one and still have to have a year of braces at 14 or 15 than have messed up teeth from 7-15 and then have 2 1/2 years of braces once lol. Not everybody will feel that way but I do, and I want to make treatment as easy for my daughter as I can.
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Steph in Sac
- Posts: 160
- Joined: Thu Feb 11, 2010 2:18 pm
As a teenager, I had to wear braces from age 13 to 16 1/2. Not fun. I don't think they even did "phase I and II" back then (I'm 37).
My daughter is 7 and I took her in for a consultation. They did x-rays and found everything is coming in fine. She will need a retainer for a slight crossbite, and then we'll just let the permanent ones fall where they may. She may be out of the woods for braces, but if not, I imagine she'd just need them for a very short time.
So, I can see why you posed the question regarding expenses and all, but I think this new process is more child-friendly.
My daughter is 7 and I took her in for a consultation. They did x-rays and found everything is coming in fine. She will need a retainer for a slight crossbite, and then we'll just let the permanent ones fall where they may. She may be out of the woods for braces, but if not, I imagine she'd just need them for a very short time.
So, I can see why you posed the question regarding expenses and all, but I think this new process is more child-friendly.
Two phase braces was not a good program for us, though I'm sure everyone is different. Part of the angst ended up being that there was no break between the phases.
My daughter got her braces two months after her 8th birthday, and got them off a few months before her 14th. So, she was in braces for almost exactly five years.
In addition to the extreme length of treatment, the worst consequence ended up being that she was terrible about brushing her teeth. We knew that going into it, and she was too young to understand the consequence. I'm not sure how other parents do it, but any comments about "We'll take the braces off" got a reply of, "Please do, I'm sick of them." But we couldn't take them off, the treatment was in progress and at various times, her jaws didn't line up. This was not unexpected, but, you can't stop once you start.
So, she has nicely aligned, discolored teeth. And she'll probably end up in braces again as an adult because even at 13, she *still* does not grasp consequence, won't wear retainers. And she still doesn't brush.
On the cost front, the entire treatment, end to end was paid for upfront. The doctor had a deal that if you paid in full, there was a 10% discount. She's completed his treatment from his perspective. She won't wear the retainers, so, nothing else he or we can do.
My daughter got her braces two months after her 8th birthday, and got them off a few months before her 14th. So, she was in braces for almost exactly five years.
In addition to the extreme length of treatment, the worst consequence ended up being that she was terrible about brushing her teeth. We knew that going into it, and she was too young to understand the consequence. I'm not sure how other parents do it, but any comments about "We'll take the braces off" got a reply of, "Please do, I'm sick of them." But we couldn't take them off, the treatment was in progress and at various times, her jaws didn't line up. This was not unexpected, but, you can't stop once you start.
So, she has nicely aligned, discolored teeth. And she'll probably end up in braces again as an adult because even at 13, she *still* does not grasp consequence, won't wear retainers. And she still doesn't brush.
On the cost front, the entire treatment, end to end was paid for upfront. The doctor had a deal that if you paid in full, there was a 10% discount. She's completed his treatment from his perspective. She won't wear the retainers, so, nothing else he or we can do.
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browneyedgrl
- Posts: 1302
- Joined: Sat Mar 10, 2007 9:29 pm
- Location: Central Florida
- Contact:
I did phase one and phase two when I was a teenager and ended up having to go through again 27 years later.
I'm all for phase one/two treatment if it's necessary. I brought my son to the ortho for the first time at 10. I could have started phase one treatment and my ortho advised me that if my son was having confidence issues, to go ahead, but he suggested that we wait. He followed him for two years and my son started comprehensive treatment 3 months ago and he's doing great!
B
I'm all for phase one/two treatment if it's necessary. I brought my son to the ortho for the first time at 10. I could have started phase one treatment and my ortho advised me that if my son was having confidence issues, to go ahead, but he suggested that we wait. He followed him for two years and my son started comprehensive treatment 3 months ago and he's doing great!
B
Started the journey for the second time on January 10th 2008~Ceramic uppers and metal lowers. Removed on June 2nd 2009.
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Re: Phase I and Phase II Ortho Treatment
This is all good info. Much like Steph in Sac, my parents weren't offered Phase I and II either. I was put in braces at 8. They came off at 14. Retainer until 15. This was in the late 80's.
My daughter, whose 8, will be starting Phase I, with an expander next week. Her teeth need room to come in or she'll have over-crowding, as did I at that age. We're all hoping that with assistance from the expander, her teeth will come in pretty straight on their own. With minimal time in braces or a retainer for Phase II. Interesting to watch this unfold.
My daughter, whose 8, will be starting Phase I, with an expander next week. Her teeth need room to come in or she'll have over-crowding, as did I at that age. We're all hoping that with assistance from the expander, her teeth will come in pretty straight on their own. With minimal time in braces or a retainer for Phase II. Interesting to watch this unfold.
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drgnchsr36
- Posts: 690
- Joined: Thu Nov 04, 2010 10:26 am
Re:
I think that's the difficult part. I don't think kids really grasp or care about their teeth at that age. Doesn't matter what parents state and say.. to be honest, I wasn't great at flossing until recently and my parents nagged me all the time about it. As an adult, I get the consequences of poor oral hygiene. Kids usually don't get it until they grow up. :/ Maybe showing pictures of poor hygiene will help.Reina wrote:Two phase braces was not a good program for us, though I'm sure everyone is different. Part of the angst ended up being that there was no break between the phases.
My daughter got her braces two months after her 8th birthday, and got them off a few months before her 14th. So, she was in braces for almost exactly five years.
In addition to the extreme length of treatment, the worst consequence ended up being that she was terrible about brushing her teeth. We knew that going into it, and she was too young to understand the consequence. I'm not sure how other parents do it, but any comments about "We'll take the braces off" got a reply of, "Please do, I'm sick of them." But we couldn't take them off, the treatment was in progress and at various times, her jaws didn't line up. This was not unexpected, but, you can't stop once you start.
So, she has nicely aligned, discolored teeth. And she'll probably end up in braces again as an adult because even at 13, she *still* does not grasp consequence, won't wear retainers. And she still doesn't brush.
On the cost front, the entire treatment, end to end was paid for upfront. The doctor had a deal that if you paid in full, there was a 10% discount. She's completed his treatment from his perspective. She won't wear the retainers, so, nothing else he or we can do.
Re: Phase I and Phase II Ortho Treatment
Because I didn't get ortho treatment when I was young, I have had to endure not only braces, but also two jaw surgeries to correct my bite. Phase I treatment would have prevented all of this. I have three children and two have had phase I treatment. The treament has prevented both from having major bite problems as they grow. Many issues (jaw size) can only be corrected while a child is still growing. So Yes Phase I is very important for many children.
RPE in on Jan 7, 2008
SARPE on Jan 11, 2008 expanded 7 mm
RPE out on May 14, 2008
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sweetcynic
- Posts: 111
- Joined: Fri Jul 20, 2012 4:42 pm
Re: Phase I and Phase II Ortho Treatment
My understanding is that it is useful for limited purposes(such as crossbites), but that 2 phase treatment on average, for more common problems such as overbites, spacing, and crowding increases total treatment time but does not improve outcomes compared to 1 phase treatment - For a study, see http://www.ncbi.nlm.nih.gov/pubmed/18249291.
In my own anecdotal, personal experience, phase 1 was a waste of my parents' money and my discomfort. Twenty years later, I'm getting extractions so that my ortho can be done effectively. Then again, I had/have an overbite, which the phase 1 treatment did not address at all.
In my own anecdotal, personal experience, phase 1 was a waste of my parents' money and my discomfort. Twenty years later, I'm getting extractions so that my ortho can be done effectively. Then again, I had/have an overbite, which the phase 1 treatment did not address at all.
See my progress at http://www.archwired.com/phpbb2/viewtop ... 80#p414180
Re: Phase I and Phase II Ortho Treatment
My daughter is currently completing phase 2 of braces. She had the first set placed at age 8.
I feel that we avoided MAJOR extractions by doing phase 1 treatment. Also, seeing the before and after pictures of her teeth were just phenomenal. She had such overcrowding before. By the time we were finishing phase 1, we had lost pretty much all of the baby teeth she had left. Basically, I would say that she had a guided eruption.
This treatment has dramatically cut down on her time in phase 2 braces. I think she would have been in treatment 3 years without early intervention. She will be in braces about 18 months this time and honestly, she feels like her braces are no big deal. She is great at using her elastics and the application of her braces, along with the adjustments, don't seem to bother her.
I got my braces and thought I was going to die. For her - it was no big deal. We have gone through a weird hygiene phase where she wasn't as good about brushing her teeth or her overall dental hygiene because it "took too long".
So I have reverted back to treating her like a baby. I stand there and I make sure she brushes at least 5 minutes in the AM and PM (Sonicare), uses the WaterPik, flosses (Superfloss) and uses mouth rinse every night. I hate it that we have to remind her to do these things, because at age 8 she was doing pretty much everything by herself without help or much prompting (except flossing). This phase should turn around, but I find it weird that teens can be harder to tune into this than the elementary school aged kids in phase 1 braces.
I feel that we avoided MAJOR extractions by doing phase 1 treatment. Also, seeing the before and after pictures of her teeth were just phenomenal. She had such overcrowding before. By the time we were finishing phase 1, we had lost pretty much all of the baby teeth she had left. Basically, I would say that she had a guided eruption.
This treatment has dramatically cut down on her time in phase 2 braces. I think she would have been in treatment 3 years without early intervention. She will be in braces about 18 months this time and honestly, she feels like her braces are no big deal. She is great at using her elastics and the application of her braces, along with the adjustments, don't seem to bother her.
I got my braces and thought I was going to die. For her - it was no big deal. We have gone through a weird hygiene phase where she wasn't as good about brushing her teeth or her overall dental hygiene because it "took too long".
So I have reverted back to treating her like a baby. I stand there and I make sure she brushes at least 5 minutes in the AM and PM (Sonicare), uses the WaterPik, flosses (Superfloss) and uses mouth rinse every night. I hate it that we have to remind her to do these things, because at age 8 she was doing pretty much everything by herself without help or much prompting (except flossing). This phase should turn around, but I find it weird that teens can be harder to tune into this than the elementary school aged kids in phase 1 braces.
Re: Phase I and Phase II Ortho Treatment
My 12 yr old just completed one year on Phase I and just got his braces off. Before we started his canines were coming in at a 45 degree angle with no room at all to move down. Phase I braces openned up space for them. He is now in retainers for a year or two to see how they come in., Then we will do braces again to align everything else.
Braces on: 2/25/2013. Braces Off: 12/23/2015
Current Retainers: Hawley Top, Essix Bottom, and Permanent Lingual Bottom
Current Retainers: Hawley Top, Essix Bottom, and Permanent Lingual Bottom
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Sookysunky
- Posts: 6
- Joined: Sat May 17, 2014 2:04 am
Re: Phase I and Phase II Ortho Treatment
Usually phase I is necessary if there is trouble with the sequence of new teeth coming in. For example my daughter's incisor came in back by the 6-year molar. Once the canine and premolar come in, they could end up permanently transposed, so we needed to fix it now. I've read in the academic literature that it's common to do phase I treatment for crossbite or underbite and/or if bite issues could cause damage to permanent teeth. It can also be done if there are self esteem issues with waiting.
However I've read studies that compared one phase to two phase treatments. a two phase treatment will end up costing more money overall with more time in braces overall. So if the issue is simply crowding and not bite or sequence or self esteem, then waiting should be advised.
I also found an interesting paper where they took identical twins with severe underbite and gave one a two phase treatment age 9-10 and 16-18 the other a one phase treatment starting age 16. By the age 20 they both had exactly the same results. The girl with the phase one treatment had less time in phase two than her sister but more time in braces overall. (The paper was demonstrating some new device that allows a correction for underbite without the need for two phases of treatment.)
I had a two phase treatment in the mid 1970s starting when I was in grade two, so this option has been available for a long time. The problem was similar to my daughter but not as extreme.
However I've read studies that compared one phase to two phase treatments. a two phase treatment will end up costing more money overall with more time in braces overall. So if the issue is simply crowding and not bite or sequence or self esteem, then waiting should be advised.
I also found an interesting paper where they took identical twins with severe underbite and gave one a two phase treatment age 9-10 and 16-18 the other a one phase treatment starting age 16. By the age 20 they both had exactly the same results. The girl with the phase one treatment had less time in phase two than her sister but more time in braces overall. (The paper was demonstrating some new device that allows a correction for underbite without the need for two phases of treatment.)
I had a two phase treatment in the mid 1970s starting when I was in grade two, so this option has been available for a long time. The problem was similar to my daughter but not as extreme.
Re: Phase I and Phase II Ortho Treatment
I'm all for Phase I treatment for kids who are likely to be very compliant. My son is about to begin his, at age 8, because his first 8 adult teeth are already seriously overcrowded and I really don't know where the others will go in the next few years if we don't make room for them.
I benefited greatly from Phase I treatment (ages 7 to 9 in the late '80s -- major overcrowding) and was told at age 12 I wouldn't need Phase II after all. 20+ years later, here I am, about to get braced to fix bite and overcrowding issues that didn't develop until my late teens. As annoyed as I am, I have to admit that I probably wouldn't have worn retainers faithfully through my 20s, and maybe I'd be needed to be rebraced now in my 30s either way. (Sigh.)
I benefited greatly from Phase I treatment (ages 7 to 9 in the late '80s -- major overcrowding) and was told at age 12 I wouldn't need Phase II after all. 20+ years later, here I am, about to get braced to fix bite and overcrowding issues that didn't develop until my late teens. As annoyed as I am, I have to admit that I probably wouldn't have worn retainers faithfully through my 20s, and maybe I'd be needed to be rebraced now in my 30s either way. (Sigh.)
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Trickycoolj
- Posts: 25
- Joined: Wed Apr 15, 2015 10:23 pm
Re: Phase I and Phase II Ortho Treatment
I had phase I in the early 1990s at 9. I don't know what exactly all my appliances did, burnin know I had an overbite/jet and not enough room with severely overlapping upper incisors. 4 brackets, headgear, bite plate, and LLA for a year made it so I never needed extractions (except impacted wisdom teeth at 20). I am infinitely grateful to my mom for getting the early treatment despite never going back for phase II (in Invisalign now at 30). Braces are a super cool status symbol in elementary school. Not so much in junior high or high school when you're starting to date. My best friend would have probably avoided 6 extractions had her parents not waited until 16, but it took that long to save the money. For any expansion case it's 100% worth it. Especially after personally watching another college friend do full up braces and big time jaw surgery at 25 for her underbite. Her face shape changed so much over summer no one recognized her. Probably best to have that kind of dramatic facial change during childhood when you're growing anyway.