Early Two-Phase Approach

Healthy Foundations Begin with Early Insight

A child’s teeth, jaws, and facial structures continue to change as they grow. An early orthodontic evaluation gives Dr. Eimar an opportunity to understand how that development is progressing, identify concerns that may benefit from attention, and determine the most appropriate time to act.

The Canadian Association of Orthodontists recommends that every child see an orthodontic specialist no later than age seven. At this stage, children usually have a combination of baby and permanent teeth, allowing an orthodontist to evaluate tooth eruption, available space, bite relationships, and jaw development before growth is complete.

An early evaluation does not automatically mean early treatment. Many children simply benefit from periodic monitoring as their teeth and jaws continue to develop. When treatment is appropriate, it is recommended thoughtfully and only when acting during growth may create a meaningful advantage.

What We Consider During an Early Evaluation

• How the upper and lower jaws are growing

• The eruption and position of developing permanent teeth

• Available space and developing crowding

• Narrow dental arches and crossbites

• Overbites, underbites, open bites, deep bites, and excessive overjet

• Jaw relationships and facial balance

• Chewing, biting, and oral function

• Mouth breathing and oral habits that may affect development

• Early or delayed loss of baby teeth

• The most appropriate timing for monitoring or treatment

These concerns reflect the signs currently identified by Braces Plus, including narrow arches, crowding, abnormal eruption, crossbites, underbites, open bites, overbites, deep bites, excessive overjet, and differences in jaw position.

Your Experience at Braces Plus

Your child’s first visit begins with a conversation. Dr. Eimar will listen to your concerns, review your child’s dental and health history, assess their teeth and bite, and consider how the jaws and smile are developing.

After the assessment, he will explain what he sees in clear, parent-friendly language. There are generally three possible next steps:

No Treatment Is Currently Needed
Your child’s development appears to be progressing well, and no further orthodontic care may be necessary at this time.

Growth and Development Monitoring
Treatment may be helpful later, so your child will return periodically while Dr. Eimar observes tooth eruption, bite changes, and jaw growth.

Early Treatment Is Recommended
A developing concern may benefit from being addressed while your child is still growing.

Early Insight care does not mean treating every child early. It means understanding what is happening, watching development carefully, and recommending care only when the timing and potential benefit are appropriate. The American Association of Orthodontists similarly notes that many children are best treated in one comprehensive phase, while selected concerns may benefit from earlier intervention.

Understanding Two-Phase Treatment

Two-phase orthodontic treatment is a specialized approach completed at two different stages of a child’s dental development. Phase One usually begins while both baby and permanent teeth are present. Phase Two generally begins later, after most or all permanent teeth have erupted.

Not every child needs two phases of treatment. Dr. Eimar recommends this approach only when early guidance may improve development, function, or the conditions for future permanent teeth.

Phase One: Guiding Healthy Development

Phase One focuses on a concern that may be most effectively addressed while the jaws and face are still growing. Depending on the child’s needs, treatment may help:

• Guide jaw growth and bite development

• Improve the relationship between the upper and lower jaws

• Create additional space for permanent teeth

• Address crossbites, underbites, or other developing bite concerns

• Reduce the effects of certain oral habits

• Improve chewing and functional relationships

• Support a healthier path for permanent tooth eruption

Treatment is individualized and may involve an orthodontic appliance, expansion, limited braces, clear aligners, or another approach selected for the child’s specific needs. Early treatment is not intended simply to straighten baby teeth for appearance. Its purpose is to address a developing concern when growth may provide an important opportunity.

Growth and Monitoring Period

After Phase One is complete, there is usually a period of observation while the jaws continue to grow and the remaining permanent teeth emerge.

Although active treatment has paused, your child’s orthodontic care has not been forgotten. Dr. Eimar will schedule periodic visits to monitor development, evaluate how the Phase One improvements are holding, and determine the most appropriate timing for the next stage.

This resting period allows natural growth and tooth eruption to continue before final alignment begins.

Phase Two: Refining the Smile and Bite

Phase Two usually begins when most or all permanent teeth have erupted. At this stage, braces or clear aligners may be used to move the teeth into their final positions and refine how the upper and lower teeth fit together.

The goals of Phase Two may include:

• Aligning the permanent teeth

• Refining the bite and jaw relationships

• Supporting comfortable, effective function

• Creating a balanced and confident smile

• Establishing long-term stability

• Completing retention planning

Phase One creates a healthier foundation when early intervention is appropriate. Phase Two builds on that foundation to complete alignment and create the final functional and aesthetic result.

Signs Worth Discussing Early

Parents do not need to diagnose an orthodontic concern themselves. However, an early assessment may be helpful when you notice:

Crowding or Limited Space
Permanent teeth appear to be emerging without enough room or in unusual positions.

Crossbite or Jaw Shifting
Some upper teeth sit inside the lower teeth, or the jaw shifts to one side when closing.

Underbite or Protruding Lower Jaw
The lower teeth or jaw sit ahead of the upper teeth.

Excessive Overbite or Overjet
The upper front teeth overlap significantly or project noticeably ahead of the lower teeth.

Open Bite
The front teeth do not meet when the back teeth are together.

Narrow Dental Arches
The upper jaw appears narrow or the teeth do not fit together comfortably.

Early or Delayed Tooth Loss
Baby teeth are lost much earlier or later than expected.

Abnormal Tooth Eruption
Permanent teeth emerge in unusual positions or fail to appear when expected.

Persistent Oral Habits
Thumb or finger sucking, tongue thrusting, or other habits appear to be affecting the teeth or bite.

Chronic Open-Mouth Posture or Mouth Breathing
Frequent mouth breathing or an open-mouth resting posture may warrant discussion and, when appropriate, collaboration with another healthcare professional.

The presence of one of these signs does not necessarily mean your child needs immediate treatment. An evaluation helps families understand what is happening and whether treatment, monitoring, or another professional assessment is appropriate.