59 Phenix Ave Cranston, RI 02920
What is Two-Phase Orthodontic Treatment
Two-phase orthodontic treatment is a carefully sequenced approach that addresses both the teeth and the underlying jaw and facial structures — at the times in your child's development when those changes are most effective.
Unlike standard orthodontic treatment, which typically begins in early adolescence when all permanent teeth have erupted, two-phase treatment begins earlier — often between ages 7 and 10 — to take advantage of your child's natural jaw growth. This early window allows Dr. Cosmo to guide development proactively, rather than compensating for problems that have already fully formed.
The purpose of two-phase treatment is to accomplish the ideal healthy, functional, and aesthetic result in the most conservative way possible — and to make it last.
What Happens if Treatment is Put Off?
Delaying orthodontic care when early intervention is warranted can result in more invasive, more complex, and more costly treatment later in life. In some cases, problems that could have been resolved with a simple appliance at age 8 may require jaw surgery or permanent tooth extractions by adolescence. Early treatment is almost always the more effective path.
Phase One
The goal of Phase One treatment is to guide the developing jaw so it can properly accommodate all of the permanent teeth and improve the way the upper and lower jaws function together. This phase addresses the skeletal and structural foundation of your child's smile — before all the permanent teeth have erupted.
Children often show early signs of jaw problems as they grow. An upper jaw that is growing too quickly or too narrowly can create bite issues, breathing problems, and crowding that compound over time. Dr. Cosmo is trained to recognize these signs early — and to act at precisely the right moment to intercept them.
At Cranston Orthodontics, children over the age of six who are found to have jaw discrepancies are candidates for early Phase One treatment. If children around the age of eight have crowded front teeth, early treatment can often prevent the need to extract permanent teeth later — a significant benefit for your child's long-term oral health.
Phase One treatment gives your child the opportunity to:
- Prevent the removal of permanent teeth later in life
- Reduce the need for surgical procedures to realign the jaws
- Correct crossbites, underbites, and narrow arches while the jaw is still growing
- Create space for erupting permanent teeth to come in properly
- Lower the overall complexity and duration of Phase Two treatment
Resting Period
Between Phase One and Phase Two, your child will enter what we call the resting period. During this phase, the remaining permanent teeth are left to erupt naturally. Retaining devices are generally not used at this stage, as they could interfere with normal tooth eruption — and giving permanent teeth some freedom of movement is an important part of the process.
A successful Phase One will have already created the space and structural conditions for permanent teeth to erupt into a healthy path. Without this foundation, incoming teeth may become impacted, severely crowded, or displaced.
At the end of Phase One, teeth are not yet in their final positions — and that's by design. The completion of alignment is the goal of Phase Two. During the resting period, Dr. Cosmo and our team will continue to monitor your child's progress through periodic recall appointments, typically every six months. Selective removal of certain baby teeth may be recommended at this stage to help guide eruption and set up a seamless transition into Phase Two.
Phase Two
The goal of Phase Two is to bring every tooth to its precise, ideal location — in perfect harmony with the lips, cheeks, tongue, and all other teeth. When this equilibrium is established, the teeth function together properly, the bite is stable, and the smile is beautiful.
Phase Two typically involves full upper and lower braces or clear aligners, and begins when all permanent teeth have erupted — usually between ages 11 and 13.
At the beginning of Phase One, Dr. Cosmo established a complete diagnosis and treatment plan. The work done in Phase One — correcting the jaw, creating space, and guiding tooth eruption — means that Phase Two is more straightforward, more predictable, and often shorter than it would have been without the early foundation.
Phase Two typically lasts an average of 18 to 24 months, depending on the complexity of the case. Upon completion, retainers are worn to ensure the final result is maintained and your child keeps their beautiful smile for life.
Why Families in Cranston Trust Dr. Cosmo With Their Children's Smiles
Dr. Cosmo is among the select 6% of orthodontists in the country certified by the American Board of Orthodontics — a distinction that reflects his advanced training, clinical excellence, and ongoing commitment to the highest standards of care. His 27+ years treating children in Rhode Island have given him a rare depth of expertise in identifying and managing complex developmental cases.
At Cranston Orthodontics, two-phase treatment isn't a one-size-fits-all protocol. Every child receives a personalized evaluation, a customized treatment plan, and the close oversight of Dr. Cosmo at every step. We use the most advanced diagnostic technology available — including cone beam 3D imaging, digital scans, and Anatomage software — to ensure that every decision is grounded in precise, individualized data.
We also offer complimentary new patient exams and free virtual smile evaluations for families who want to explore whether two-phase treatment may be right for their child — with no commitment required.
Schedule a Free Exam for Your Child Today
If your child is approaching age 7 or you've noticed signs of a developing bite or jaw issue, the time to act is now. The earlier Dr. Cosmo can evaluate your child, the more options we have — and the simpler the path forward.
Schedule a complimentary new patient exam at Cranston Orthodontics today. We'll walk you through exactly where your child is in their development, what we're watching for, and whether any treatment — now or in the future — makes sense for them.