Two-Phase Orthodontic Treatment
Cincinnati, Fairfield, & West Chester, OH
 Two-phase orthodontic treatment at Nelson R. Diers Orthodontics helps growing children in Cincinnati, Fairfield, and West Chester, OH avoid bigger problems later by correcting bite and jaw issues in two well-timed stages.
The first phase guides jaw growth while a child still has a mix of baby and adult teeth. The second phase, years later, straightens the full set of permanent teeth once they have come in.
If you are a parent trying to decide whether your child needs treatment now or whether you can wait, this page is meant to help you understand the choice. Two-phase treatment is not right for every child, and plenty of kids do beautifully with a single round of braces in their teens. The point of an early evaluation is simply to find out which path fits your child, part of the orthodontic care we provide for every age.
The children who benefit most from a two-phase approach usually have a developing problem that is easier to steer while the jaw is still growing. Catching it in that window can mean a simpler, more stable result and, in many cases, fewer extractions down the road.
On This Page
What Is Two-Phase Orthodontic Treatment?
 Two-phase orthodontic treatment splits care into two separate stages with a break in between. The first phase happens while a child still has a mix of baby and permanent teeth, usually between ages seven and ten. The second phase happens in the early teens, once most of the permanent teeth are in.
The two phases do different jobs. Phase one is about guiding growth: making room for incoming teeth, influencing how the jaws develop, and heading off problems such as crowding, crossbites, or the effects of thumb sucking before they become harder to fix. We cover what Phase 1 treatment involves in more depth on its own page. Phase two is the full treatment stage, where braces or aligners straighten the complete set of permanent teeth and refine the bite.
Does Your Child Need Two Phases?
Most children do not need two-phase treatment, so an evaluation is really about finding the ones who do. Signs that an early look is worth it include:
- Early or late loss of baby teeth, or teeth that come in looking very crowded.
- An underbite or crossbite, where the upper and lower teeth do not line up correctly.
- A narrow upper jaw or trouble biting and chewing.
- Thumb or finger sucking that has continued past about age five or six.
- Jaws that look or feel out of balance as the face develops.
The American Association of Orthodontists recommends a first orthodontic check by age seven for exactly this reason. An early visit does not mean treatment starts right away. Often the best move is simply to watch your child’s growth and begin only when the timing is right.
Your Child’s Orthodontist
Dr. Nelson R. Diers, DDS, MSD is a board-certified orthodontist and a Diplomate of the American Board of Orthodontics, with more than 45 years of experience. He earned his Doctor of Dental Surgery from Northwestern University and his Master of Science in Dentistry from Indiana University, where he serves on the orthodontic faculty. His full bio covers his training in detail.
Guiding a growing child takes a different kind of judgment than treating an adult, because the goal is to work with the jaws as they develop rather than against them. Dr. Diers evaluates children as young as three when there is reason to, and he favors growth guidance over removing permanent teeth whenever it is possible. That patient, watch-and-time approach is exactly what good two-phase care depends on.
For your family, that means recommendations grounded in more than 45 years of watching how young jaws grow, and an orthodontist who will tell you honestly when to start, when to wait, and when no treatment is needed at all.
How Two-Phase Treatment Works, Step by Step
Two-phase treatment spreads across several years, but a child spends only part of that time in active treatment. The plan moves through three stages, with a long resting period in the middle.
Phase One: Guiding Growth
Phase one usually begins between ages seven and ten and lasts somewhere around six to twelve months. Depending on what your child needs, we may take an i-CAT 3D scan to see how the jaws are developing, then use an appliance built in our in-house lab, or a partial set of braces, to make room, widen a narrow jaw, or correct a crossbite. The aim is to fix the underlying growth issue, not to straighten every tooth yet.
The Resting Period
After phase one, most children take a break from active treatment, often a year or two, while the rest of the permanent teeth come in. During this time we simply keep an eye on things with periodic check-ins. Your child can be a kid, with no braces and no appliances, until the teeth are ready for the next stage.
Phase Two: Aligning the Permanent Teeth
Phase two starts in the early teens, once most or all of the permanent teeth have erupted. This is the full-correction stage, using braces or clear aligners to straighten the smile and settle the bite. Because phase one already handled the harder skeletal groundwork, phase two is often shorter and more straightforward than it would have been otherwise. A retainer afterward keeps the result in place.
Benefits of Two-Phase Treatment
 The biggest benefit of two-phase treatment is timing. Guiding a growth problem while the jaws are still forming can accomplish things that become difficult or impossible once a child stops growing. Our practice leans into that window deliberately, which is why we are able to avoid removing permanent teeth in the great majority of cases.
Working with a child’s growth also protects more than the smile. Because our orthodontist weighs the airway and jaw joints alongside tooth position, early treatment here is aimed at how your child breathes and how the bite functions, not appearance alone. That whole-system view is the heart of our holistic approach to orthodontic care.
- Fewer extractions – Because we guide the jaws to develop with enough room, our patients rarely need permanent teeth removed.
- Airway and jaw-joint health – We plan around breathing and joint function from the very first evaluation, not just straight teeth.
- A simpler second phase – With the skeletal groundwork done early, phase two in our office is frequently shorter.
- Less guesswork on timing – With more than 45 years of watching young jaws grow, we start each phase when it will do the most good.
None of this is guaranteed for every child, and we will be candid about what early treatment can realistically achieve for yours.
Why Choose Our Practice for Two-Phase Treatment
Early treatment decisions are easy to get wrong in both directions: starting too soon, or waiting too long. The experience to call it correctly is what sets Nelson R. Diers Orthodontics apart. Our board-certified orthodontist has guided growing smiles for more than 45 years, and our team carries well over a century of combined experience.
We also lean toward conservative, growth-friendly care, which means recommending treatment only when it will make a real difference and rarely removing permanent teeth. When a phase-one appliance is needed, our in-house lab builds it to exact specifications, which keeps the fit precise and the turnaround quick. For the braces themselves, our office uses the Damon System, which our orthodontist helped design.
With offices in Cincinnati, Fairfield, and West Chester, families across the area can find a convenient location, and your child can be seen by the same familiar team from the first evaluation through the last retainer check.
Two-Phase Treatment Cost and Financing
Cost matters, and we want to be straight with you about it. With two-phase treatment, we plan and bill the two phases as separate stages, so you are not paying for everything at once. The cost of each phase depends on what your child needs and how long that stage takes.
Orthodontic insurance often includes a lifetime maximum benefit for treatment, and how it applies across two phases varies by plan. Our team files your claims and helps you understand your coverage. You can read more about how we handle orthodontic insurance before you start.
Flexible payment options are available, including no-interest monthly plans, a discount for paying in full, and third-party financing. You can review our financing options online. Call us at (513) 829-4400 to talk through an estimate after your child’s evaluation.
Schedule Your Child’s Orthodontic Evaluation
The simplest next step is an evaluation to see whether your child needs treatment now or later. Call Nelson R. Diers Orthodontics at (513) 829-4400 to schedule a new patient exam in Cincinnati, Fairfield, or West Chester, OH. Our main office is at 1251 Nilles Rd, Suite 14, Fairfield, OH 45014-7205. You can also reach us through our Contact page with any questions before you book.
Frequently Asked Questions
What age should my child start two-phase treatment?Phase one usually begins between ages seven and ten, while a child still has a mix of baby and permanent teeth. The evaluation itself should happen earlier, around age seven, even if treatment is years away. The right starting age depends on the problem, since a crossbite often needs attention sooner than mild crowding does.
Will my child be in braces the whole time?No, and this surprises a lot of parents. Active treatment happens only during phase one, which runs about six to twelve months, and phase two in the teens. The year or two in between needs no braces or appliances at all, so the total time wearing anything is far shorter than the overall span suggests.
Is two-phase treatment really necessary, or can we wait for one round of braces?For many children, one round of braces in the teens is plenty, and we will say so. Two phases make sense when an early growth problem, such as a crossbite or a developing underbite, is much easier to correct while the jaws are still forming. Waiting in those cases can turn a simple early correction into a longer, harder one later, and in rare cases into surgical orthodontics once growth is finished.
What if it turns out my child only needs one phase?That happens, and it is a good outcome. Sometimes an early evaluation shows no phase-one treatment is needed and we simply monitor until the teens. Other times phase one resolves the problem so well that a full second phase is not necessary. We only recommend the treatment your child actually needs.
Does early treatment hurt my young child?Phase-one appliances and braces cause some soreness for a few days when they are first placed or adjusted, much like any orthodontic treatment, and it eases quickly. Children generally adapt faster than adults do. We take time to show your child how everything works so the experience feels manageable rather than scary.
Can two-phase treatment help my child avoid having teeth pulled?Often, yes. By guiding the jaws to develop with enough room early on, two-phase treatment frequently makes it possible to keep all of the permanent teeth. Our practice rarely recommends removing permanent teeth, because doing so can affect the airway, the bite, and the balance of the face.
What are the treatment options in phase two?Phase two typically uses braces or clear aligners to straighten the permanent teeth. Many teens choose Invisalign for teens for a less noticeable option, while others do well with the Damon System braces our office uses. We help your family pick the approach that fits your teen’s case and lifestyle.
Why should I choose your practice for two-phase treatment in Cincinnati?Two-phase timing is a judgment call, and our orthodontist is board-certified and on the orthodontic faculty at Indiana University, with more than 45 years guiding growing patients. That experience is what tells us when to start, when to wait, and when to do nothing at all. Families across Cincinnati, Fairfield, and West Chester also value seeing the same team at whichever office is closest. |
