What is Phase I (Early Interceptive Treatment) and Phase II treatment?
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| Herbst Appliance |
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| Palatal Expander |
Phase I or Early Interceptive Treatment usually starts while the child has most of their baby teeth with few of their permanent teeth. The goal of Phase I treatment is to intercept moderate or severe orthodontic problems early in order to reduce or eliminate them. These problems include jaw bone problems, cross bites and developing crowding. This phase does not use full braces as braces are never put on baby teeth. Generally we use expanders, removable appliances, herbst appliance (instead of headgear) and retainers during this phase. This treatment approaches takes advantage of the active growth to change the jaw bone structure to either make extra room or address jaw bone discrepancies. This helps reduce the need for extractions or jaw surgery and delivers better long term results and treatment options. Most Phase I patients require a Phase II treatment in order to achieve an ideal bite.
Phase II treatment involves use of full braces to with a goal to finish the occlusion or bite ideally. It usually occurs when all permanent teeth are present. Many times there is gap of time between Phase I and start of Phase II treatment. This phase most commonly occurs around the age of 12 or 13 years.
Expander: A fixed device given to expand or stretch the upper jaw. At a growing age the upper jaw is not one piece of jaw bone but divided into two parts at the middle of the roof of the mouth. The expander stretches the suture in this area. This treatment is used to gain space (to prevent extraction) as a wider arch means more room. It also corrects cross bites and creates wider beautiful smiles. It is better to do the expansion as early as possible. Expander is generally given on the upper teeth only as the upper jaw covers the lower. Also, as upper jaw is expanded the lower follows the upper and expands naturally most of the times.
Herbst Appliance: This treatment is given to address large overjets/overbites caused by skeletal (jaw) discrepancies. This device has generally replaced headgears which are also given to address such situations. The Herbst appliance has helped us to stop using headgears in our office for the last several years.
The Herbst appliance consists of hydraulic like devices that go on the crowns cemented on back molars. This fixed device propels the lower jaw forward and pushes the upper back to address the antero-posterior jaw discrepancies. Again, earlier this treatment is given, better the response of growth achieved.
