Phase I Orthodontic Treatment: A Parent’s Guide

Most parents assume orthodontic treatment starts in the tween or early teen years, once all the permanent teeth are in. For many children, that’s accurate. But for some, there is a window of opportunity much earlier than that, when treatment is not only possible but significantly more effective than waiting. That window is called Phase I.

Families in Wilmington, Hockessin, Pike Creek, and Newark, Delaware, as well as bordering communities in Pennsylvania, New Jersey, and Maryland, including Kennett Square, Avondale, Elkton, and surrounding areas, bring their children to Rawlins Orthodontics for early evaluations every week. This guide explains what Phase I is, when it’s needed, and what to expect.

Phase I, also called early intervention or interceptive orthodontics, is a limited course of orthodontic treatment for children typically between ages seven and ten who have a mix of baby and permanent teeth. It targets specific developmental problems, such as crossbites, jaw width discrepancies, and significant crowding, that respond better to treatment while the jaw is still actively growing. Not every child needs Phase I. When it is recommended, it is because clinical evidence supports intervention at that stage over waiting.

What Phase I Is

Phase I is not full braces and it’s not simply a starter course of treatment. It’s a targeted, limited intervention designed to correct a specific issue that is best addressed while the jaw is still growing. Phase I treatment typically uses appliances like expanders, partial braces, or space maintainers to guide jaw development or correct bite problems before all the permanent teeth have arrived.

As Dr. R. Baker Rawlins II explains: “Phase I is about using the growth that’s already happening. When we address a narrow upper arch or a crossbite at age eight, we’re working with the body’s natural process. If we wait until fifteen, the jaw has largely finished growing and our options look very different.”

Why Timing Matters

The jaw is most responsive during active growth, which in most children is between ages seven and eleven. Certain problems can be corrected with minimal effort during this window that would require more complex treatment, longer treatment time, or even surgical intervention if left until adolescence or adulthood.

A crossbite that isn’t corrected early can lead to uneven jaw development. A narrow upper arch that could be expanded easily at age eight becomes far more difficult to treat after growth has slowed. The AAO recommends a first orthodontic evaluation at age seven for this reason: to identify developing issues when intervention is most effective.

Common Issues Treated in Phase I

• Crossbites involving the front or back teeth that cause the jaw to shift to one side
• Narrow upper arch or palate that doesn’t leave adequate room for erupting permanent teeth
• Significant crowding in the front teeth that can be addressed with early expansion
• Underbites where the lower jaw protrudes in front of the upper jaw
• Habits like prolonged thumb-sucking that have affected jaw development
• Severe spacing issues that may affect how permanent teeth erupt

Not all children with these conditions need Phase I treatment. Dr. Rawlins evaluates the severity of the issue, the child’s age and growth stage, and whether waiting would create a meaningfully worse outcome before recommending early intervention.

The Gap Between Phase I and Phase II

Phase I is followed by a resting period during which the remaining permanent teeth erupt. The child is monitored during this time, typically with check-ins every six months, to track development and determine when the time is right to begin Phase II comprehensive treatment. Retaining devices are sometimes used during this period, and selective baby tooth removal may occasionally be recommended to guide eruption.

Phase II usually involves full upper and lower braces or Invisalign Teen to finalize alignment and bite once all the permanent teeth are in. Having completed Phase I often makes Phase II shorter, less complex, or both.

Investment and Insurance for Phase I

Phase I treatment is a separate investment from comprehensive Phase II treatment. The total will vary based on the type of appliance used and the treatment duration. Most private orthodontic insurance plans include coverage that may apply to Phase I treatment, though this reduces the lifetime benefit available for Phase II.

Our Treatment Coordinator walks every family through the investment, insurance coordination, and payment options for Phase I at the consultation. We explain how the benefit distribution across both phases works so families can plan accordingly. There are no surprises.

Frequently Asked Questions

How do I know if my child needs Phase I?

The only reliable way to know is a clinical evaluation by a Board-Certified Orthodontist. Certain signs may suggest early evaluation is warranted, including crowded front teeth, a visible jaw shift when biting down, mouth breathing, difficulty chewing, or early or late loss of baby teeth. The AAO recommends every child be evaluated by age seven regardless of visible concerns.

Does every child who has Phase I need Phase II?

Most children who complete Phase I do still go on to Phase II comprehensive treatment. Phase I addresses specific developmental issues but is not typically sufficient to complete the full alignment and bite correction needed. The value is that Phase II is often simpler, shorter, or less intensive as a result of Phase I.

What if we skip Phase I and wait?

For children who don’t clinically need Phase I, waiting is the right answer. For children where Phase I is recommended, waiting means allowing a developmental issue to progress during a period when it’s easiest to correct. Dr. Rawlins is clear about when Phase I is clinically indicated versus when monitoring and waiting is the appropriate plan.

How long does Phase I treatment take?

Most Phase I treatment plans run six to twelve months, depending on the type of appliance and the issue being corrected. Some expansion and bite-correction cases can be completed closer to the six-month end of that range. Dr. Rawlins gives a specific estimate at the consultation based on the clinical findings.

Schedule Your Child’s Free Evaluation

We serve families throughout Wilmington, Hockessin, Pike Creek, and Newark, Delaware, as well as bordering communities in Pennsylvania, New Jersey, and Maryland, including Kennett Square, Avondale, Elkton, and surrounding areas. Schedule your free consultation online at RawlinsOrthodontics.com/appointment-request or call us at (302) 239-3531. You’re in good hands with our Rockstar Team, and we’ll walk you through everything.

About Rawlins Orthodontics

Rawlins Orthodontics is a family-owned, Board-Certified orthodontic practice serving Wilmington, Hockessin, Pike Creek, and Newark, Delaware, as well as bordering communities in Pennsylvania, New Jersey, and Maryland, including Kennett Square, Avondale, Elkton, and surrounding areas. R. Baker Rawlins II, DMD, MS has cared for thousands of patients since 2011 and is named annually as one of Delaware’s Top Orthodontists by Delaware Today Magazine. We offer braces, Invisalign, Invisalign Teen, and early intervention orthodontics for children and adults.

Schedule a free consultation with Dr. Rawlins at RawlinsOrthodontics.com.

5500 Skyline Drive, Suite 1, Wilmington, DE 19808

(302) 239-3531 | RawlinsOrthodontics.com

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