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Two-Phase Orthodontics in Atlanta, GA

Braces and other orthodontic devices seem to be more popular among younger children. But is it really necessary to put children as young as seven in braces? The answer is maybe. For children with emerging orthodontic issues, breaking treatment up into two phases can decrease treatment time, lessen discomfort and save money. For other children, waiting until the teenage years is just fine. So how do you know what is right for your child? If you live in the Atlanta area and have a child who is seven years old, now is the time to visit iClear Orthodontics to see if early intervention is necessary. Board-certified orthodontists Dr. Ruchir Patel and Dr. Kal Thakkar are available at their Alpharetta, Roswell and Kennesaw locations to answer any questions you have regarding your child’s dental development and two-phase orthodontics.

What Is Phase I/Phase II Orthodontic Treatment And How Is It Different From Other Orthodontic Treatment That Takes Place?

Traditionally, orthodontic treatment was reserved for older children and teenagers and was administered in one block of time. Modern orthodontic research indicates, however, that starting treatment early is beneficial for some children. In these cases, orthodontic treatment is rendered in two phases rather than one. The Phase I typically happens when the child still has baby teeth. Corrections are made that allow the permanent teeth to have the best possible results when they erupt. When Phase I treatment is completed, there is a resting period where the child wears a retainer or does not have any treatment at all. Phase II allows the orthodontist to make remaining corrections after all permanent teeth are in place.

What Is Advantageous About Two-Phase Orthodontic Treatment?

A dual-phased treatment allows early intervention that could potentially make treatment less invasive, shorter and not as expensive in the future. The process considers changes that not only straighten the teeth and bite but also affect the overall facial structure. In some cases, early treatment can eliminate the need to pull permanent teeth later on or even prevent the need for surgical procedures to align the jaw.

What If Treatment Is Delayed?

Many people wait until their children are older to seek treatment for a variety of reasons. These children also get the cosmetic and functional benefits of orthodontics.  However, children who have not benefited from earlier intervention may experience a longer, more complex and more painful treatment than they otherwise would have. For example, if a six-year-old has an overly narrow jaw, corrective orthodontic treatment could prevent future crowding. The treatment could also possibly eliminate the need to extract permanent teeth.

What Is Phase I Orthodontic Treatment?

Phase I orthodontic treatment is administered to children aged seven to 10 who have not yet lost all of their primary teeth.

During Phase I, orthodontic treatment is focused on jaw development. The goal is to ensure that the jaw has enough room for all of the permanent teeth to fit properly once they erupt. For example, over or underdevelopment of the jaw can be diagnosed and corrected early to prevent gaps, crowding or cosmetic effects from appearing a few years later.

Phase I Treatment Benefits

Early orthodontic treatment has many advantages including:


  • Manipulates jaw shape for optimal alignment during growth
  • Corrects the width of dental arches
  • Reduces or potentially eliminates the need for jaw surgery
  • Reduces the chance that permanent teeth will need to be extracted
  • Guides permanent teeth into appropriate positions
  • Makes Phase II treatment time shorter and easier


  • Corrects oral habits, including thumb or finger-sucking and pacifier use that can push the teeth out of position
  • Improves speech impediments caused by jaw and bite alignment


  • Improves cosmetic appearance leading to higher self-esteem

Do All Children Need Phase I Orthodontic Treatment?

Not all children are candidates for Phase I intervention, but many are. Children who have a moderate to severe underbite, open bite or crossbite would benefit from Phase I treatment. Children with severe crowding may also be eligible. Keep in mind that some Phase I treatments include braces, but not all do. Often, appliances, such as retainers or palatal expanders, will do the job.

Resting Period

The time between Phase I and Phase II treatment is considered a resting period. The teeth remain untouched while the remaining permanent teeth break through. In some cases, retainers are used. In other cases, it is best to leave as much room as possible for the permanent teeth. Periodic follow-up appointments are required during this time to monitor progress and changes.

What is Phase II Orthodontic Treatment?

After Phase I treatment is complete, the teeth are not in their final positions. This is accomplished during the second phase of treatment. Phase II treatment is less complex and shorter than what would have otherwise been required without a first phase.  Because some of the work has already been done, orthodontic treatment may be as simple as moving the teeth into the proper position or improving the bite.

How Long Do The Phases Take?

Treatment length will depend upon the type and severity of the issue. In general, Phase I treatment typically takes between six and 18 months for children between the ages of seven and 10 years old. The resting phase which gives time for the permanent teeth to erupt typically takes 12 to 24 months and Phase II orthodontic treatment usually lasts from 12 to 24 months as well.

What Is Comprehensive Treatment?

Some patients do not require a phased approach but instead, need to wait until around the age of 12 to have the treatment done all at once. Comprehensive treatment often takes advantage of growth spurts to facilitate treatment.

During comprehensive treatment, traditional braces are used in conjunction with other procedures or devices, such as extractions or a Forsus™ fatigue resistant device, after most of the permanent teeth are already in place. Comprehensive treatment typically lasts from 12 to 30 months depending upon the severity of orthodontic issues.

Why Should All Children Be Examined By An Orthodontist At Age Seven, According To The American Association Of Orthodontists?

Permanent teeth begin to erupt around age seven which enables Dr. Patel and Dr. Thakkar to determine if there is enough space available for the remaining permanent teeth to move into the correct position. Bite problems and jaw misalignment can be diagnosed as well at this age. Early screening is an essential tool for ensuring that small orthodontic problems do not escalate into bigger ones down the road.

Early screening for orthodontic issues gives you peace of mind. You are able to catch emerging issues early and feel confident about waiting. If you live in the Greater Atlanta Area and are interested in learning more about two-phase treatment, contact Dr. Ruchir Patel and Dr. Kal Thakkar at iClear Orthodontics located in Alpharetta, Roswell, and Kennesaw for an appointment Monday through Saturday.

"I am another happy patient at iClear Orthodontics! I am in invisalign treatment and can already see changes in 4 months! I have been to both Roswell and Alpharetta locations and they are very contemporary and up to date! 5 stars all the way!" - Emily Thomas
"Dr. Patel and his staff are incredible! We (I and my 12 year old daughter) recommend his orthodontic services to everyone we know when they say they need orthodontics done right. The staff at his office is friendly, and they know how to answer questions, which goes a long way toward feeling comfortable with an orthodontist. Our 12 year old child now has a beautiful smile, and it’s all thanks to his excellent care. He never recommends orthodontic treatment unless it's needed, and that really makes a difference. Our 2nd…" - Kimberly T
"Dr. Thakkar and the staff at iClear Orthodontics are completely professional, from start to finish. They explain the process, the treatments, and even go over our insurance with us so that we know how our claims will be handled. There were no questions that didn’t have an answer, and by the time we left his office, I was sure that I wouldn’t want to send my kids to anyone else for the services he offers" - Justin D. Thomson
"We love visiting their Kennesaw location... Great staff, very pleasant and honest orthodontist and our 10 year old loves Dr Patel! Only issue we have sometimes is traffic at 5pm... We try to schedule our appointments around 3:30 to beat the Chastain Rd traffic." - Karen Houstin