How do you decide about phase I of braces?

[JustMe]

So, I know the big thing today with orthodontists is to do both phase I and phase II of braces. Our insurance covers none of this. How do you decide if you should do phase I or just wait? I really don't care about fixing her smile now, that she is more open to it now, etc. If it would be less expensive to just wait and they could do a good job I would just as well wait, but its hard to get a straight answer about that.

[missliss55]

DD1 is doing phase I right now. She just braces last week. She started with an expander retainer for 9 months. Hers is more about fixing her bite (she has a cross bite) and not about fixing crooked teeth (her teeth are straight with good spacing).

[KLD313]

I've never heard of phase 1 and phase 2 so looked it up out of curiosity and found this.

http://www.bracesquestions.com/static/braces-intro/children-braces/phase-one-1/

Sounds like it depends on what problem needs to be corrected.

[erosenst]

We're doing phase I and phase II. DD had an expander, which added a great deal of much needed room for her wildly overcrowded upper teeth. In theory, she should need less work in phase II because of this, so the total cost will be less.

Having said that - in hindsight I would have waited til her top four permanent teeth were fully in, or at least asked more about it. While we created space for her canines (which were twisted 90 degrees), she'll be in the initial phase of braces for at least 6 months longer than planned because the fourth tooth took a while to fall out...and is taking FOREVER to come back in.

She didn't mind the expander (which is a little more painful the closer they are to the palate fully closing) and had exactly one day of trauma about the braces themselves. Part of the trauma was that she was the first in her class to have them.

Think a couple of orthodontists can likely give you the best answer for your situation, but thought an example might help.

[MichelleRC]

We are starting phase 1 in October with DS2. We are waiting for the upper canine teeth to come in, although they may not since the baby ones fell out a year ago and there is no space for the permanent ones to come in. He also has a pretty considerable cross bite. If it were just cosmetic, I may have waited a bit.

[smilequeen]

I think it depends on the situation.

But in general, it's not going to hurt to do 2 phases. And they can probably fix whatever it is later. But if the first phase is indicated, it often makes the 2nd phase easier, faster, and more successful.

My older boys both have appliances right now (ages 5 and 7).

[ssjarrett]

You might get a second opinion. One ortho recommended phase 1 with a palate expander and phase 2 later for my 8 year old with a cross bite and immediately sent us contracts to sign.

Went to another ortho for a second opinion and they don't do palate expanders and just prefer to fix it all at once--said they could fix the bite with the baby teeth, but then permanent teeth may very well come in in cross bite too. Part of what sold me on waiting and just doing it all at once was the long time of being in phase 1 followed by retainers for years until you get to phase 2--just wasn't right for us. It will also cost less to do one phase.

We will go each year for a free consult with 2nd ortho to monitor changes until ready for braces as a young teen.

Good luck!

[KrisM]

I've never heard of phase 1 and phase 2 so looked it up out of curiosity and found this.

http://www.bracesquestions.com/static/braces-intro/children-braces/phase-one-1/

Sounds like it depends on what problem needs to be corrected.

That is what our ortho told us. He prefers to wait unless it's something that needs to be done early.

[JustMe]

Thanks so much everyone! Its so hard to know what to do! We are getting a total of 3 consultations, the last of which is tomorrow. So far the first 2 all said she needs phase I. OTOH, maybe I am cynical but I feel like most orthos. would say lets start now, put money in my pocket now.

[smiles33]

DH is an orthodontist and has a bunch of before/after photos on his website. Several of those were two-phase patients, but at least a few only did Phase 1 and then decided the results were nice enough to skip Phase 2. I don't know the details, obviously, and I never had braces myself so I don't know exactly how the stuff works, but I gather from casual conversations with DH that if you work with a younger child during Phase 1, you can react to new challenges as s/he grows, rather than waiting until later when it may be too late to "guide" growth. That makes sense to me, though I can see how it sounds to you like a lame attempt to just get you in the door earlier to get your money.

Anyhow, hope you get some satisfactory answers from the orthodontists you're seeing.

[Kindra178]

If you do this, ask about braces impeding root growth/length. My sister had an old school version of Phase I and II. Now, at 42, her dentist advised that her roots are really short due to years of ortho intervention (braces x 2, spacer). She now apparently needs $20,000 plus of dental work (uncovered by insurance, of course).