Phase 1 Child Orthodontic Treatment in Bryn MawrPhase 1 Child Orthodontic Treatment in Bryn Mawr

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Phase 1 Child Orthodontic Treatment: What You Need to Know

Phase 1 Child Orthodontic Treatment: What You Need to Know

Dr. Karen Conn of Bryn Mawr Orthodontics explains early childhood orthodontics and why it's important to be conservative about Phase 1 treatment

By Dr. Karen Conn (Bryn Mawr Orthodontics) 

At Bryn Mawr Orthodontics, we endorse the American Association of Orthodontists (AAO) guidelines, which recommend that all children have a screening with an orthodontic specialist no later than age 7.  However, we are generally very conservative about treating younger children with appliances, such as, spacers, expanders, or Phase 1 braces.  Oftentimes, during screening appointments for young children, we simply recommend additional appointments every 6 months or 1 year to monitor the child's growth and development.  However, in roughly 5-10% of young patients, Phase 1 orthodontic treatment, also known as interceptive orthodontics, is recommended.  Phase 1 treatment is designed to address problems that can only be corrected at this younger age or to minimize the need for more involved and complicated orthodontic treatments in the future.

What is Phase 1 Orthodontic Treatment?

Phase 1 child orthodontic treatment is typically performed between the ages of 7 and 10.  During this time, children are in the mixed dentition stage, which means they have a mix of baby teeth and permanent teeth.  Phase 1 treatment can help to correct problems, such as:

  • Crossbite
  • Underbite
  • Excessive Overjet
  • Severe Crowding
  • Habits, such as thumb sucking, finger sucking, tongue thrusting and mouth breathing

Phase 1 child orthodontic treatment can be done with a variety of appliances, including:

  • Expander: an appliance placed on the roof of the mouth to expand the upper jaw to alleviate crowding, crossbites, and other issues
  • Space Maintainer: a fixed or removable appliance that can help after a baby tooth is lost early.  It can protect the space young patients need for their adult teeth to emerge
  • Biteplate: a fixed or removable appliance that is used to correct a deep overbite or an anterior open bite
  • Retainer: a customized appliance that keeps your teeth straight and holds spaces for adult teeth to erupt
  • Tongue Crib: a fixed or removable appliance that is used in rare circumstances to help with a thumb sucking habit, finger sucking habit, or tongue thrusting habit 
  • Bluegrass Appliance: a fixed or removable appliance that is used to help train the tongue in patients with a tongue thrusting habit

Phase 1 child orthodontic treatment can also be done with braces or Invisalign First.  Invisalign First is a clear aligner treatment designed for children between the ages of 6 and 10.

The specific appliance that is used will depend on the individual needs of the child.  When it comes to a big decision like Phase 1 child orthodontic treatment, it is particularly important that parents and the orthodontist are on the same page about the appliance being used and the overall game plan for treatment.

Advantages of Phase 1 Child Orthodontic Treatment (When It Is Needed)

There are several advantages to having Phase 1 child orthodontic treatment when it is needed:

  • Treatment can be more predictable at an early age.
  • Phase 1 treatment can help prevent a more serious problem from developing later on.  For example, by catching a problem early, an orthodontist can recommend treatment to prevent the need for a surgical procedure in the future. 
  • Phase 1 treatment can help prevent injury or trauma to the front teeth.  In an active child, Phase 1 treatment can put the teeth in a better position to avoid injury or prevent future dental work to restore damaged teeth.
  • Phase 1 treatment can help a child's speech or confidence.  By properly correcting the angulation of the teeth and closing certain gaps, early orthodontic treatment can improve certain speech impediments.
  • In a patient with a habit, a consultation with the right orthodontist at the right time can be the extra push that child needs to break a strong habit such as thumb sucking.  We often work with children and their parents to give them the best tips and tricks to help a child stop a longtime habit, which can naturally improve the position of the teeth without any active orthodontic treatment.

Why It's Important to Be Conservative About Phase 1 Child Orthodontic Treatment

Phase 1 child orthodontic treatment can absolutely be necessary for some young children. However, it's important to be conservative with this type of treatment, as too much early intervention (for example, the overuse of expanders or space maintainers) can actually do more harm than good.  After all, a young child’s jaws are still growing and developing; their teeth are still erupting; and their other facial features are still maturing.  When we design smiles, we perform comprehensive analyses not only of a patient’s teeth, but of the entire face - this includes facial structure, the contours of lips, the visibility of gums, and a patient’s profile from different angles.  In developing our recommendations, we are very thoughtful about the effect Phase 1 child orthodontics will have on each of these components of a perfect, healthy smile.

For all these reasons, it's important to talk to your orthodontist about the risks and benefits of Phase 1 child orthodontic treatment before you make a decision.  Make sure your orthodontist has done a thorough exam of your child and has shown you the impact treatment will have on your child’s “forever smile.”  

If your child does need treatment, your orthodontist should work with you to develop a conservative treatment plan that will help them achieve a beautiful, healthy smile without damaging their developing jaws and teeth.

When to Consider Phase 1 Orthodontic Treatment

If you are concerned about your child's teeth and oral health, talk to your child’s dentist and schedule a free consultation with an orthodontist.  The orthodontist will be able to assess your child's teeth and jaws and recommend the best course of treatment.


Karen Conn, DMD, MS is a Board-certified orthodontist and co-owner of Bryn Mawr Orthodontics (Bryn Mawr, PA), where she specializes in Invisalign and braces for children, teens and adults.  She has been recognized as a Philadelphia Magazine Top Dentist, Main Line Today Top Dentist, Suburban Family Top Orthodontist, and is among the nation’s top 1% of Invisalign providers.  Dr. Conn received her undergraduate and doctorate degrees from the University of Pennsylvania.  She completed her residency in Orthodontics and Dentofacial Orthopedics at Temple University, where she also earned a master's degree in Oral Biology.

Bryn Mawr Orthodontics serves its neighbors in Bryn Mawr, Gladwyne, Villanova, Ardmore, Haverford, Wynnewood, Narberth, Radnor, Penn Valley, Bala Cynwyd, Merion, Wayne, and the entire Main Line.

To learn more about Bryn Mawr Orthodontics contact the office today (484-383-0055) or schedule a free consultation online.

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