After phase 1 orthodontics, patients generally begin phase 2 of orthodontic treatment during early adolescent or adolescent years. During this phase of treatment, teeth are aligned for maximum esthetics, function and stability with braces and specialized retainers or expansion appliances, if needed. Missing teeth may be replaced during this stage, and teeth that are out of position or fail to erupt may be brought down into the dental arch or removed.

Patients with craniofacial anomalies often have complex orthodontic and dental needs that require specialized treatments and services. Our team has specialized training in orthodontic treatment of patients with craniofacial conditions, including cleft lip and palate, craniosynostosis, and hemifacial microsomia.

Common orthodontic and dental complexities seen in these conditions include: missing teeth, extra teeth, teeth that fail to erupt, missing or lack of adequate bone after grafting procedures, and altered patterns of jaw growth. Using the most advanced technology, our team can take low-dose radiation 3D X-rays that allow us to carefully assess your child’s needs and plan treatment in these complex situations.

It is possible that orthodontics alone will not be sufficient to correct your child’s bite. The most common reason for this is that the jaw has not developed properly. For example, the upper and lower jaws may each be too large, too small or have developed asymmetrically. Patients with cleft lip and palate, hemifacial microsomia, Pierre-Robin syndrome, craniosynostosis, Treacher Collins syndrome, and ectodermal dysplasia may all exhibit these altered growth patterns. These jaw development issues may also occur independent of any syndrome or medical diagnosis.

In these cases, a combination of orthodontics and orthognathic (jaw) surgery may be the ideal treatment. If so, phase 2 orthodontics may be limited so that the teeth are straightened, but the bite is not corrected. Final orthodontic treatment and correction of the bite will be postponed until your child is skeletally mature and a candidate for jaw surgery.

Phase 2 orthodontic treatment lasts approximately 12 to 30 months, depending on the severity of the problem and whether or not your child is a candidate for jaw surgery.

Updated March 2019