Phase 1 Orthodontic Treatment—also known as Step 2 in our developmental approach—builds upon the foundation established during early craniofacial development. This phase typically begins around age 9, once the upper and lower front four permanent teeth have erupted. For patients who have not completed the initial foundational expansion, both steps can be combined, starting with expanders and transitioning directly into aligner therapy.
During this stage, we continue expansion to further create space for the tongue and support balanced facial growth. At the same time, we begin improving aesthetic alignment using clear aligners such as Candid® or Invisalign®. Each week, your child advances to a new set of aligners that gently widen and guide the teeth into improved alignment and function.
Once the upper expander is no longer cemented, we can begin working more directly on tongue posture and muscle function through myofunctional therapy. This includes exercises taught in our office and the use of a Myobrace® appliance, which helps train the tongue to rest on the roof of the mouth, strengthen oral and facial muscles, and guide proper jaw positioning. Myobrace therapy is an important companion to aligner treatment—because muscles play a key role in shaping bone, proper muscle function is essential for long-term orthodontic stability. Our goal is to ensure nasal breathing, tongue strength, and a proper swallow pattern to prevent relapse and promote lifelong stability.
This phase of treatment typically lasts about 12 months. Although not all permanent teeth have erupted at the end of this stage, retainers may be worn temporarily to maintain results while waiting for full dental development. Patients visit every 4 to 6 weeks for progress checks, new myofunctional exercises, and cranial manipulations—gentle techniques used to support healthy movement of the 22 cranial bones and maintain facial symmetry. These manipulations help relieve restrictions in the cranial sutures, which can become tight from growth patterns or minor childhood trauma, and help optimize overall balance and alignment.
Our Phase 1 Orthodontic Program helps set the stage for lasting results—combining airway-focused expansion, gentle alignment, and functional muscle training to create strong, confident smiles that last a lifetime.
Contact our office today to schedule an evaluation and learn if your child is ready for Phase 1 orthodontic treatment.