Two-Phase Orthodontics: A Special Kind of Treatment

From a historical perspective, orthodontic philosophies and concepts evolved around treating the permanent dentition.

Therefore, orthodontists were taught to wait until all the permanent teeth had erupted before initiating orthodontic treatment. Many of the studies in orthodontics also evolved around these philosophies, concepts and principles. Consequently, any contributing factors to poor dental-facial growth and development were ignored, as were the ways to treat such factors.

Simply put, orthodontists became mechanics responsible for moving teeth.

As individual orthodontists, and as a profession as a whole, we need to be more proactive, interceptive and preventive. We must treat patients in such a way that they head down a good path of dental-facial growth and development. Dr. Hietanen, Dr. Dusel and I feel very strongly about this, and feel it will lead to more stable and nicer looking results for our patients.

In order to reach a better understanding of what we are talking about, you need to understand some of the philosophies and concepts of early orthodontic treatment.

– Dominic A. Colarusso, Jr., DDS

Early orthodontics utilizes growth in its favor. By age four, 60% of facial growth is accomplished. By age six, 80% of this growth is complete. By age 11 (or when the second molars have erupted), 90% of facial growth is complete.
• First Phase Treatment (Interceptive)
• Intermediate Retention Period (Rest Phase)
• Second Phase Treatment (Corrective)

“What to Look For” Early Warning Signs Indicating it is Time for an Orthodontic Exam:
• Crowding, misplaced, or blocked-out teeth
• Early or late loss of deciduous (baby) teeth
• Mouth breathing
• Finger sucking or other oral habits
• Difficulty in chewing or biting
• Protruding teeth
• Jaws that shift, make sounds, protrude or retrude
• Teeth that meet in an abnormal way or don’t meet at all
• Facial imbalance or asymmetry
• Speech difficulty
• Biting the cheek or biting into the roof of the mouth
• Grinding or clenching of teeth