Written by Keith R. Dobrin, DMD, MBA, ABO Board-Certified Orthodontist

Understanding Phase I Orthodontic Treatment: Interceptive Therapy

At Bancroft Dobrin Orthodontics, we strive to provide the best care for your child’s orthodontic needs. A few months ago, we discussed when a child should first visit an orthodontist. While your pediatric or general dentist is usually excellent at making timely referrals, it’s important to remember that both the orthodontic and pediatric societies recommend that children be evaluated around the age of seven. But why is this the case? Why not wait until they are older?

Why Early Evaluation Matters

Decades ago, orthodontic treatment typically began after all permanent teeth had erupted, leading to a lengthy 3 – 4 year process. However, recent studies have shown that early intervention, known as Phase I Orthodontic Treatment or Interceptive Therapy, can significantly reduce the need for extended treatment times and prevent the extraction of permanent teeth later on. This early therapy helps develop and prepare the maxilla and mandible—the bones that house the upper and lower teeth—allowing for more predictable eruption of permanent teeth.

However, while a baseline evaluation is recommended around age seven, we often wait until the child is between eight and ten years old, depending on the severity of the case and the child’s maturity level. This is because orthodontic treatment requires a certain degree of maturity, awareness, and compliance, which we carefully assess during our evaluations.

Indications for Phase I Treatment

So, what exactly are the indicators for Phase I Orthodontic Treatment? If you notice any signs from the detailed graphic we provide during consultations, it may be time to consider early treatment. These issues often present in combinations or evolve over time.

One common indication for Phase I treatment is a crossbite. Normally, the upper teeth should slightly overlap the lower teeth. If the lower teeth are outside the upper teeth in a crossbite or underbite, this can hinder proper skeletal growth and potentially cause trauma, leading to gum recession and bone loss. Whether the misalignment is in the front or back, early intervention is crucial to correct the problem and ensure normal growth.

Another common issue is overcrowding, which can prevent or impact the eruption of canines, also known as the “eye teeth.” If these teeth do not have enough space to emerge, they may become stuck in the bone or erupt abnormally. In such cases, creating additional space is essential to avoid long-term complications.

Custom Treatment Plans for Every Child

If your child’s teeth resemble any of the images we’ve discussed, you might wonder, “What do we do next?” At Bancroft Dobrin Orthodontics, we take the time to thoroughly diagnose each case and create a customized treatment plan tailored to your child’s specific needs. There is no one-size-fits-all approach here—every patient is unique and requires different interventions.

One common treatment in Phase I is the use of a palatal expander, particularly for resolving crossbites and space deficiencies caused by overcrowding. We typically use a fixed or permanent palatal expander for the upper teeth during this phase of treatment. This appliance is worn for about 4-6 months and is removed once the treatment is complete. Patients usually adapt to it within a day or two.

Why Choose a Fixed Expander?

A fixed expander is preferred because it allows us to make gradual skeletal changes, providing more room for teeth to grow while simultaneously resolving bite issues. It also acts as a space maintainer, ensuring the desired results are achieved and maintained. Research shows that fixed expanders are more effective than removable ones in terms of predictability, stability, and long-term success.

On average, the first phase of treatment at Bancroft Dobrin Orthodontics lasts about 9-12 months and may include limited braces to align the teeth aesthetically. We have successfully treated hundreds of patients each year with this approach, and our results speak for themselves.

Schedule a Complimentary Consultation

There is no harm in bringing your child in for an evaluation, even if it turns out that no treatment is needed yet. However, delaying treatment could lead to more significant issues down the line. At Bancroft Dobrin Orthodontics, we offer complimentary consultations, and if no treatment is necessary, your child will be placed in our recall system for future monitoring.

As the holiday season approaches, we at Bancroft Dobrin Orthodontics wish you and your family a happy and healthy season!

Contact Us

For more information or to schedule a complimentary consultation, please contact us:

Waldwick Office:
Phone: (201) 447-1611
Address: 90 Franklin Turnpike, Waldwick, NJ 07463

Teaneck Office:
Phone: (201) 692-1455
Address: 175 Cedar Lane, Suite 1, Teaneck, NJ 07666

About Dr. Keith Dobrin

Dr. Keith Dobrin, of Bancroft Dobrin Orthodontics and XtraOrdinary Smiles Orthodontics, is a recognized orthodontic specialist with advanced education in Orthodontics and Dentofacial Orthopedics. His research on braces adhering to teeth has been published, and his expertise has led to him being selected to test various orthodontic products from national companies. Schedule your complimentary consultation with Dr. Dobrin today!