Two-Phase Treatment
Two-Phase Treatment occurs when a child needs early orthodontic treatment during the time when the permanent teeth are erupting and some of the baby teeth are present. Reasons for early treatment may include difficulty in chewing or biting, breathing through the mouth, thumb-sucking, crowded or misplaced teeth, jaws that are too far forward or back, protruding teeth, upper and lower teeth that do not meet or meet in an abnormal way, or grinding or clenching of the teeth. The American Association of Orthodontists recommends children see an orthodontist at age 7 to evaluate any discrepancies in jaw growth and emerging teeth. Some orthodontic problems are easier to correct if they are detected early. If no problems are detected, the child will be monitored periodically under supervision appointments, and Dr. Fravel will supervise the growth and development of the child, pinpointing the best time for orthodontic treatment, if necessary.
Phase I Orthodontic Treatment
Phase I Orthodontic Treatment occurs if an early growth and development discrepancy is detected. The goal of the first phase of treatment is to develop the jaw size in order to accommodate all the permanent teeth and after eruption to relate the upper and lower jaws to each other. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper or lower jaw that is growing too much or not enough can be recognized at an early age. If children as young as four years of age are found to have jaw discrepancy, they are candidates for orthodontic treatment. Because they are growing rapidly, children can benefit enormously from orthodontic treatment utilizing strategies that increase space for unerupted permanent teeth, correct overcrowding and/or surgical procedures and align upper and lower jaws. Leaving such a condition untreated until all of the permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with braces alone.
After Phase I treatment, a resting phase is neccessary to allow the eruption of all permanent teeth. In this phase, the orthodontic appliances from Phase I are removed and retaining devices (retainers) are sometimes recommended to hold the space created for unerupted permanent teeth. Occasionally a retainer is not necessary to allow the existing permanent teeth some 
freedom of movement while final eruption of the teeth occurs. A successful first phase will have created room for teeth to find a more favorable eruption path. This decreases the possibility of becoming impacted or severely displaced. It is important to note that at the end of the first phase of treatment, your child’s teeth may not be in their final position. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be necessary for the eruption of permanent teeth during the resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a three to six month basis.
Phase II Orthodontic Treatment
Phase II Orthodontic Treatment occurs after eruption of all permanent teeth is nearly complete. With a good foundation established in the first phase and normal growth during the resting period, the second phase can be carried out to complete the alignment of the teeth, in the same manner as Full Orthodontic Treatment. New retainers are made and worn after this phase.
Full Orthodontic Treatment
Full Orthodontic Treatment occurs when all of the permanent teeth have erupted, normally around age 12. However, teenage children are not the only candidates for full orthodontic treatment. Adults make up about 25 percent of orthodontic patients. Each patient is different, but treatment generally takes 1-3 years to complete depending on the complexity of the case. During treatment, adjustments to the braces are made ever 8-12 weeks. Retainers will be made and should be worn to retain the teeth in their final position.
Invisalign®
Invisalign® is offered as a treatment option as an alternative to braces for some patients with full adult dentition and complete jaw growth. The system uses a series of clear orthodontic aligners that are virtually undetectable to other people. The aligners are more comfortable to wear than traditional braces and can be removed for eating and brushing. As an orthodontic specialist certified in the Invisalign® program, Dr. Fravel is pleased to discuss this treatment option during the initial evaluation and determine if Invisalign® is the best option for your orthodontic care.