What is phase 1 orthodontics? It is early orthodontic treatment (interceptive orthodontics) while your child is in mixed dentition and still growing usually between ages 6 and 9. A child who has some adult teeth a lot more baby teeth in his/her mouth than permanent/adult teeth is in the mixed dentition and can benefit from phase 1 orthodontics. Phase 1 treatment may involve a palatal expander or it may require partial braces on only the few adult teeth that are present in the mouth. There are many types of orthodontic devices that can be used for Phase 1 orthodontics. Phase 1 treatment is usually initiated because the benefits of intervening at a younger/earlier age exceed waiting for all of the permanent/adult teeth to be present for treatment.

Palatal expanders may be used to treat crossbites, crowding, and impacted teeth in phase 1 orthodontics. A crossbite happens when a child’s upper jaw is too narrow to fit correctly with opposing lower jaw and the back top teeth bite inside of the lower teeth instead of outside Crowding is identified when there is not enough room for the permanent (adult) teeth to come in. Sometimes by widening the arch, we can avoid having extractions later to accommodate these permanent teeth. Impacted teeth are teeth that have not come in (erupted) and may be blocked by other teeth. The upper canine is one of the most commonly impacted upper teeth in mixed dentition. By widening the upper jaw, the impacted teeth can properly erupt into proper position by itself.

If a baby tooth is prematurely lost due to decay, like a baby upper or lower second molar, a fixed space maintainer like a lingual arch appliance may be recommended. If a child has a thumb sucking habit for a prolonged period, the upper arch may narrow and an anterior open bite can develop. A thumb sucking appliance like a tongue crib may be used to make it difficult for child to place thumb in the mouth and often can be effective in eliminating habit when left in 3-6 months.

A young child patient who presents with an underbite which is also referred to as an anterior crossbite or skeletal Class III malocclusion is an example of a typical case that can also benefit from phase 1 orthodontics. Orthodontists recommend that these cases, are often best to intervene at the earliest possible time rather than wait until all the permanent/adult teeth erupt. Completing Phase 1 orthodontics in an underbite case can prevent a patient with an underbite from needing to undergo(orthognathic) jaw surgery in the future for bite/jaw correction. Dentists strongly recommend an orthodontic examination or screening by age 7. Starting early orthodontic treatment with phase 1 orthodontics is often best in underbite cases as well as many other types of orthodontic problem cases that present in young kids.