Waterbury Office
650 Chase Parkway
Waterbury, CT 06708

(203) 573-8034

Southbury Office
33 Bullet Hill Road
Southbury, CT 06488

(203) 262-4500

Two-Phase Treatment

photo of red hair girl with braces

Let's Time It Right!

The Question

When is the bets time to begin orthodontic treatment? This is a question that is often asked of us by parents, especially as they see other young children in orthodontic appliances. Our specialty training in orthodontics placed emphasis both on early treatment (7-10years old) as well as treatment occurring later with all of the permanent teeth present.

My Answer

We have been fortunate to have the opportunity to treat many patients with both techniques and then review them in the following areas: finished results, duration of treatment, number of appointments, loose and broken appliances, cooperation, patient motivation and enthusiasm. Combining this information with new wire and appliance technology, We have concluded that for the vast majority (approximately 80 percent) of young patients, it is best to delay treatment until most permanent teeth are in. Additionally, numerous university studies have reached the same conclusion.

The Reasons

The five major advantages and benefits of waiting:

  1. Decreased time in braces and fewer appointments, resulting in:
    • Less chance of enamel decalcification and root shortening.
    • Less time absent from school or work.
    • Less opportunity for broken braces.
  2. Bone growth is occurring more rapidly during the adolescent years, increasing treatment effectiveness.
  3. Understanding and cooperation are better when a child is mature.
  4. Completing treatment in one phase is less costly than a prolonged two-phase program.
  5. More stable results.

The most optimal time to realize these benefits will vary somewhat with the individual child, but for most children, it is between the ages of 10 and 12. Orthodontic treatment begun during this window of opportunity will usually result in braces being on for 24 months instead of 3-4 years or more.


There are a few orthodontic conditions that do warrant a brief period of early treatment. These include:

  1. Cross bites.
  2. Severe jaw growth imbalances (such as an upper jaw that is set too far back)
  3. Space maintenance for premature loss of primary (baby) teeth.
  4. Excessive crowding causing damage to teeth, bones or gums.
  5. Airway problems.
  6. Elimination of harmful habits such as thumbsucking.

Additionally, if a young patient is suffering psychologically or socially from crooked or protruding upper front teeth, a brief period of partial braces can improve both the smile and self- image dramatically. Though braces will typically still be needed when all the teeth erupt, I do feel this is a valid treatment indication for some youngsters.

Parting Words

Needless to say, the timing of orthodontic treatment is an important issue that can make orthodontics either a rewarding and enjoyable experience or one that is prolonged and tedious. Our observation program is set up to allow us to evaluate the patient's dental and overall development on a regular basis in order to begin orthodontic treatment at the appropriate time. All observation visits are at no charge to you.

We hope that this information has given you both a better understanding of our practice and a positive introduction to orthodontics. Additionally, I hope you can see that waiting is sometimes the best "treatment".

Please feel free to contact our office if we can assist you with any questions you may have.

Dr. Mike Friedman

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