Two-phase treatment splits orthodontic care into an early phase that guides jaw growth, a resting period while the remaining permanent teeth come in, and a second phase that aligns the full bite. At Providence Orthodontics, Dr. Jessica Collins recommends it only when there is a clear reason — most children do fine with one course of treatment at the usual age.
Phase I: Guiding Growth
Phase I happens while a child still has a mix of baby and permanent teeth, generally between ages 7 and 10. The goal is not straight front teeth; it is creating the conditions for a healthy bite. That may mean widening a narrow upper arch with an expander, correcting a crossbite before it wears enamel or shifts the jaw, making room for permanent teeth that would otherwise be blocked, or addressing a habit such as thumb-sucking or mouth-breathing that is affecting development.
Phase I is usually short — often a matter of months. This is the same philosophy behind our interceptive orthodontics care: treat early where growth gives us leverage, and leave the rest until the timing is right. The American Association of Orthodontists recommends a first evaluation by age 7 so this window is not missed.
The Resting Period
After Phase I, appliances typically come out and we wait. The remaining permanent teeth erupt on their own schedule, and we monitor at periodic visits to make sure everything is coming in as expected. This stage can last a couple of years, and it is a normal, intentional part of the plan rather than a pause in care.
Some children need a retaining appliance during this period to hold the correction Phase I achieved. We will explain exactly what is needed and why.
Phase II: Finishing The Bite
Phase II begins once the permanent teeth are in, usually in the early teens. This is the full course of treatment most people picture: a complete set of brackets or a series of aligners that levels the arches, closes spaces, and detail-finishes how the upper and lower teeth meet. Depending on the case and your child’s preference, that may be metal, ceramic, or WildSmiles types of braces, or Invisalign for teens clear aligners.
Because Phase I addressed the structural problems, Phase II is often more straightforward than it would have been otherwise. Retainers follow, and consistent retainer wear is what keeps the result — teeth drift for life, and it is the most common reason patients need treatment twice.
Is Two-Phase Right For Your Child?
It depends entirely on what we see. Two-phase treatment is the right call for a minority of children with genuine growth or space issues, and unnecessary for many others. We plan from digital records taken with our iTero scanner and other orthodontic technology, and Dr. Collins will tell you plainly which category your child falls into, including when the answer is “monitor and wait.”
Questions Parents Ask About Two-Phase Treatment
- Are we paying for braces twice? The two phases are separate courses of treatment with separate fees, and the monitoring period in between is included. Our team lays out the full picture before Phase I starts — see payment options — so nothing arrives as a surprise years later.
- Could we skip Phase I and just treat later? Sometimes, and we will say so when that is the better plan. Skipping is the wrong call when a crossbite is wearing enamel, a permanent tooth is being blocked, or a narrow arch is restricting room for the tongue and airway.
- How long is the resting period? Typically a couple of years, with periodic monitoring visits while the permanent teeth erupt.
- Will my child wear an appliance the whole time? Not usually. Some children need a retaining appliance between phases to hold the Phase I correction.
Who Plans The Treatment
Dr. Jessica Collins is a board-certified orthodontist who earned her DMD at Boston University and completed her orthodontic residency at the University of Washington. Her approach to growth-stage treatment is deliberately conservative, and it considers jaw development, facial balance, and airway together rather than tooth position alone.
Records come from an iTero digital scan and, where jaw structure matters, CBCT imaging; see our orthodontic technology page. Our office is at 151 Waterman Street, Suite #6 in Providence, open Tuesday through Thursday from 8:30 a.m. to 5:00 p.m. Call (401) 274-5024, meet the Providence Orthodontics team, or read about your first visit.
Request A Free Consultation
Get a specialist’s read at no cost: request a free consultation or contact our Providence office at (401) 274-5024. If treatment is recommended, our team will review payment options with you in full before it begins.