Orthodontics for Kids

Two Phase Treatment

Does every child need two-phase Orthodontic treatment?

As Sudbury’s top kids orthodontist, we will be the first to tell you that not all kids need two-phase orthodontic treatment.  At Hometown Orthodontics, we only treat kids at an early age if it is absolutely necessary.  Most children are simply observed during their growth and development state to determine the optimum time to being treatment.  However, there are certain cases that should be treated early in order to avoid more complex and invasive treatment in the future, which may include extraction of adult teeth or surgical correction of jaw position or size.

See our Early Treatment/Prevention section to find out more about when and why we would treat children at an early age.

If my child has Early Treatment or Phase 1 treatment, will they need a second phase of treatment?

Most children who have a early treatment or interceptive treatment to correct problems will require a second, phase of comprehensive treatment.  Remember, the first phase of treatment helps to create space for adult teeth and facilitate dental development and correct problems with the growth of the jaws.  This is best done when children are young, when we can take advantage of their growth.  Once the adult teeth grow in we must align them in a favourable position to help with function and optimal hygiene.

What if I decline or delay early treatment or Phase 1 treatment?

Many parents ask us if it is really necessary to start treatment early for issues such as crossbites or open bites or habits.

The answer is an absolute YES!  If nothing else, one of the best things that you can do for your children is take advantage of their growth and development early in life and use early intervention to facilitate normal growth and dental development.  Delaying treatment can often result in more invasive treatment later in life which may not completely fix your child’s smile.  Dr. Virdee does not recommend treatment unless it is absolutely necessary.

She likes to help parents understand the difference between who really “needs” two phases, versus those that really just need one phase.  Her goal at that first appointment is to educate a parent on whether their child needs Phase I treatment and how they can benefit from it.

In some cases, two phase treatment is not needed, and in those cases Dr. Ritter will guide a family on best timing of treatment and she will keep an eye on the patient over time until treatment is needed.


Two phase orthodontic treatment starts with Phase 1 orthodontic treatment or early/interceptive treatment.  This phase is basically used to prevent future problems from developing in the first place.   Remember the American Association of Orthodontist recommends that patients see an Orthodontist as early as 7 years.  This is the time that permanent teeth start to erupt.  Seeing Dr. Virdee, a leading children’s orthodontist in Mississauga or Sudbury, will help to determine crowding, bite problems and issues with growth of the jaws.

A phase I treatment may include an appliance such as an expander or headgear or a face mask, and/or a partial set of braces to assist in correcting problems.  There are also some simple solutions to correcting early orthodontic problems, such as space maintainers to allow normal eruption of permanent teeth, or specialized retainers for minor tooth movement.  Treatment duration usually ranges from 6-18 months.  Check out our Early Treatment/Prevention page for more details.


Following Phase I treatment, there is a period where Dr. Virdee will monitor a child’s growth.  In this phase, permanent teeth are allowed to erupt naturally and retainers may not be used if they interfere with eruption of these teeth.  Remember a successful first phase of treatment will have already created room for permanent teeth to find an eruption path so that they do not become severely displaced or impacted.

During the resting phase you will be seeing Dr. Virdee for “recall appointments” every 6-12 months.  During this time, we will determine if there is a need for selective removal of certain baby teeth to help enhance the eruption of permanent teeth.

It is crucial to maintain your appointments with Dr. Virdee during this stage to confirm that the development of the teeth and jaws is occurring normally.


The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly.

Phase Two usually involves full upper and lower braces.

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was established. Certain types of appliances were used in the first phase to correct and realign the teeth and jaw. The second phase begins when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure you retain your beautiful smile.

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Make an appointment today and start your child’s journey to a healthy and beautiful smile with Hometown Orthodontics.

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