It is a common misconception that orthodontic treatment cannot occur until a child has lost all baby teeth. Phase I orthodontics is orthodontic treatment that occurs between the ages of 7 and 9, and is specifically intended to treat adult and baby teeth. Before age 7, children do not have enough adult teeth, nor have they developed enough to begin orthodontic treatment. Usually around age 7 is when the front four and back two adult teeth have come in, allowing an orthodontist to see how the bite is manifesting itself through growth. It is at this point that orthodontists have the ability to analyze the child’s teeth and bite to determine how they will develop over time. In many cases, some baby teeth may need to be removed before or during treatment to help with the development of the adult teeth, but baby teeth are often used in Phase I treatment to hold space for the adult teeth that will take their place in the future.
When I examine a child in the Phase I stage, the most common issues I look for are crowding, a crossbite relationship (where top teeth are biting on the inside of the lower teeth), a jaw discrepancy (perhaps a Bucky Beaver or Jay Leno issue), or habits, such as finger sucking, that may be creating a problem. I look for signs where the development may not be heading down a normal path hoping to intervene early to change the growth pattern to a more favorable scenario. By utilizing Phase I orthodontics, patients will often need less orthodontic work and will most likely not run the risk of needing to extract permanent teeth in Phase II when all of the adult teeth have come into place.