Phase 1 Braces In 2026: When Your Child Needs Them, And When To Wait
Written By: Logan Grover, Content Writer |
Reviewed By: Dr. Alison Grover, Board-Certified Diplomate Pediatric Dentist |
Last Reviewed: September 16, 2026 |
Most kids screened at age 7 don't need Phase 1 braces. That's the part the rest of the field leaves out.
Phase 1 braces correct 1 specific problem while a child still has a mix of baby and permanent teeth, usually between ages 6 and 10. They work. For the right problem, they save a much harder correction later. But the research supports early treatment over waiting on exactly 1 measure, and for most bites, watching is the better call.
We provide Phase 1 treatment at Mini Miners, and we still tell plenty of Erie parents to wait. Here's how we decide, what the evidence supports, and what you risk by holding off.
What Are Phase 1 Braces?
Phase 1 braces are a short, targeted round of orthodontic treatment during mixed dentition, when a child has both baby and permanent teeth. Treatment usually runs 9 to 18 months and fixes 1 problem, not the whole bite. Appliances range from partial braces to a removable device. Full alignment waits for Phase 2 in the teen years.
That's the definition. The harder question is whether your child is in the group that benefits.
Phase 1 is not early braces for a crooked smile. Crowded front teeth at 7 are normal and often resolve on their own as the jaw grows. What Phase 1 targets is a bite problem that gets worse, harder, or more expensive if left alone: a crossbite, a habit reshaping the palate, an impacted tooth, or a jaw relationship that only shifts while a child is still growing.
What The Research Says About Early Braces
Early two-phase treatment has 1 proven advantage over waiting: fewer broken front teeth. That is the finding, and it is worth understanding before you sign anything.
The Cochrane systematic review on prominent upper front teeth pooled 27 randomized trials covering 1,251 children and adolescents. Among kids treated early with a functional appliance, 19% (31 of 161) had a new front-tooth injury, against 30% (51 of 171) among those who waited for a single course as teenagers. That is moderate-quality evidence. A second comparison using headgear found 24 of 117 early-treatment kids injured versus 44 of 120 who waited, on low-quality evidence.
Then the reviewers wrote the sentence nobody quotes: "There appears to be no other advantages for providing treatment early when compared to treatment in adolescence."
The American Academy of Pediatric Dentistry says something similar in its guidance on managing the developing dentition. Class II bites "can be corrected effectively with either a single or 2-phase regimen," and two-phase treatment "results in significantly longer treatment time." The same document notes that evidence for space maintainers preventing or reducing malocclusion "is lacking," even though the profession agrees they should be considered after a baby tooth is lost early.
None of that means Phase 1 is useless. It means the case for it has to be specific to your child, not a general claim about early treatment.
Which Problems Need Phase 1 Braces?
A short list of bite problems benefits from treatment before the permanent teeth are all in. Most of the rest can wait.
We start Phase 1 for:
Crossbites, front or back. The AAPD guidance is direct here: when a crossbite makes the jaw shift to close, that shift "should be eliminated as soon as possible with early correction to avoid temporomandibular disorder and/or asymmetric growth." Correcting an anterior crossbite early also protects the enamel from wearing down.
Upper front teeth that stick out far enough to get hit. This is the Cochrane finding applied. If your child plays contact sports and the upper teeth are exposed, early treatment lowers the odds of a broken tooth.
A thumb or finger habit still going past the preschool years. The AAPD ties long-term nonnutritive sucking to open bite and posterior crossbite, and pushes for parents to help children stop "by age 36 months or younger." Past that, the palate reshapes, and an appliance often does what talking hasn't.
Severe crowding blocking a permanent tooth from coming in. An impacted tooth doesn't resolve with patience.
A permanent tooth erupting into the wrong position when the neighboring baby teeth are still holding space.
That's the list. It's shorter than most pages you'll read, and that's the point.
When We Tell Erie Parents To Wait
Waiting is the right call more often than the industry admits, and it costs nothing to reassess in 6 months.
We recommend watching when the concern is spacing or mild crowding in the front teeth, when a bite is off but not shifting the jaw, when the child's oral hygiene isn't ready for appliances, or when a habit is fading on its own. We also wait when a child isn't ready emotionally. Appliances demand daily care, food restrictions, and a string of appointments. A child who dreads the chair will not brush around brackets for 12 months, and that trade is not worth it.
There's a real cost to treating early when you didn't have to. Two-phase treatment means more total months in appliances, more visits, and a longer window for enamel to decalcify around brackets. A white spot on a permanent front tooth is permanent. We would rather watch a bite for another year than hand a 7 year old a problem they'll see in the mirror at 30.
If your child does have a jaw discrepancy severe enough that surgery is on the table later, that's a different conversation, and we've written separately about whether early treatment can head off jaw surgery.
Why Watching From Age 1 Beats One Look At Age 7
An orthodontist meeting your child at 7 sees a snapshot. We've been watching the film.
The American Association of Orthodontists recommends every child be screened by an orthodontist at age 7, and that recommendation is sound. We follow it. But there's a difference between arriving at a first evaluation cold and arriving with 6 years of records.
Mini Miners starts seeing children at age 1, or 6 months after the first tooth comes in, whichever is earlier. Families who come to us on that schedule reach the age 7 milestone having had their bite looked at close to a dozen times. We know whether that crossbite is new or has been there since the primary teeth came in. We know whether the crowding is worsening or holding steady. We know whether the thumb habit is fading.
That history changes the recommendation. A crossbite that appeared last year and a crossbite that has been shifting the jaw since age 4 are not the same case, and you cannot tell them apart from a single panoramic x-ray. It's also why we push routine exams every 6 months rather than annually. A cavity takes about 6 months to form on a baby tooth, and a bite can change in the same window.
Phase 1 Now Or Watch And Reassess
Here is the trade laid out plainly.
Start Phase 1 Now | Watch And Reassess | |
What it targets | 1 defined problem: crossbite, protruding upper teeth, habit damage, impacted tooth | Nothing yet. Monitoring growth and eruption |
Typical age | 6 to 10, during mixed dentition | Reassess every 6 months |
Time in appliances | 9 to 18 months now, plus Phase 2 later | Phase 2 only, if needed |
Evidence backing | Strong for crossbite and trauma prevention. Weaker for everything else | Cochrane found no disadvantage to waiting on any measure except front-tooth injury |
Main risk | Longer total treatment, decalcification, burnout | A correctable problem gets harder |
Best fit | A specific problem that worsens with time | Crowding, spacing, and mild bite issues in a growing child |
Does Phase 1 Mean Your Child Skips Braces Later?
Usually not. Most children who complete Phase 1 still need Phase 2 as teenagers, though the second round is often shorter and less complex.
We tell families this at the first conversation, because the alternative is a parent who feels misled 5 years later. Phase 1 corrects the problem that couldn't wait. Phase 2 aligns everything once the permanent teeth are in. They are 2 different jobs.
What Phase 1 does buy, in the right case, is a simpler Phase 2. Correcting a crossbite at 8 means the teenage bite is being aligned on a foundation that fits. It does not mean the alignment step disappears.
Can You Put Braces On Baby Teeth?
Yes, in specific cases. Baby teeth respond to gentle force the same way permanent teeth do, and they can serve as anchors while a permanent tooth is guided into place.
The roots on baby teeth are shorter, so the forces have to stay light and the plan has to account for teeth that will be lost during treatment. We don't bracket baby teeth for looks. We do it when a baby tooth is the only stable anchor available to move the tooth that matters.
If your child is losing baby teeth in an unusual order or one is late to come out, that's worth a look on its own. We cover what normal eruption looks like and when the timing signals a problem.
How Insurance Handles Two Phases Of Treatment
Orthodontic benefits are usually a lifetime maximum, not an annual one. It is a set dollar amount per person that does not reset, and whatever Phase 1 uses comes out of what's left for Phase 2.
This gets stated wrong constantly. You'll read that insurance "only covers orthodontics once," which suggests using it on Phase 1 locks you out of Phase 2 entirely. That's not how it works. The benefit is a cap, so any unused portion carries forward. What you spend early reduces what remains, but it doesn't erase it.
That distinction matters for the decision. If your child's problem needs early correction, using benefit now is the right call. If the case is borderline, drawing down a lifetime cap on optional treatment is a real cost worth weighing.
We accept all major private insurances, and families without dental coverage can use the Mini Miners Membership Plan to keep care predictable. Our front desk will run your specific benefits before treatment starts so nothing is a surprise.
What Phase 1 Looks Like At Mini Miners
We treat Phase 1 in-house, so your child stays with the team that has been seeing them since they were a toddler.
Our Erie practice offers Phase 1 orthodontics including Invisalign for kids, partial or full braces, and removable appliances for simpler cases like crossbites. Dr. Alison Grover is a Board-Certified Diplomate pediatric dentist who completed her pediatric certificate at UCLA and her DDS at the University of Colorado School of Dental Medicine. She opened Mini Miners in 2017.
The environment is built for kids who are nervous about appliances. Every treatment room is plumbed for nitrous oxide, we offer mild, moderate, and deep sedation, and x-rays are taken in the treatment room on a camera-style machine so a child can keep watching a movie through it. Kids who need to warm up first can come in for a happy visit with no treatment at all. If your child is anxious about dental visits, tell us before the appointment, not during.
We're at 61 Erie Pkwy in the Erie Commons area, at Briggs Street and Erie Parkway between I-25 and 287, a few minutes from most local schools. Families drive to us from Erie, Lafayette, Louisville, Broomfield, Boulder, Longmont, Westminster, Thornton, Arvada, Brighton, Berthoud, and Johnstown.
If you want a straight answer on whether your child needs Phase 1 braces or should wait another year, book a visit and we'll show you what we're seeing.
Questions Erie Parents Ask Us
At what age do Phase 1 braces start?
Phase 1 braces typically start between ages 6 and 10, while a child still has a mix of baby and permanent teeth. The American Association of Orthodontists recommends every child be screened by age 7, but a screening is not a treatment plan. Most children screened at 7 are placed on observation rather than started in appliances.
How long do Phase 1 braces take?
Phase 1 treatment usually runs 9 to 18 months. It ends when the specific problem it targeted is corrected, not when the whole bite is aligned. After that, most children go into a resting period and are monitored until the permanent teeth come in.
Are Phase 1 braces necessary?
For a short list of problems, yes. Crossbites that shift the jaw, upper front teeth exposed enough to be broken, habits reshaping the palate, and impacted teeth all benefit from early correction. The Cochrane review of 27 trials found early treatment reduced new front-tooth injuries from 30% to 19% compared with waiting, but found no other advantage over treating in adolescence.
What happens if we skip Phase 1?
For most bites, nothing. The problem is corrected in one round of braces as a teenager, and the Cochrane evidence found no disadvantage to that path on any measure other than front-tooth injury. For a crossbite causing a jaw shift or an impacted tooth, waiting makes the correction harder and can cause changes that don't reverse.
Does Phase 1 replace braces later?
No. Most children who finish Phase 1 still need Phase 2 in their teens, usually shorter and less complex than it would have been. Phase 1 fixes 1 problem early. Phase 2 aligns the full permanent set.
Should we see a pediatric dentist or an orthodontist first?
If your child already has a pediatric dentist, start there. A dentist who has watched the bite develop across years of checkups has context a first-time evaluation cannot match. We handle Phase 1 orthodontics in-house and refer out when a case needs a specialist.
Can Phase 1 braces damage permanent teeth?
The main risk is not the tooth movement. It's decalcification, the white spots that form when plaque sits around brackets. Those marks are permanent on adult teeth. This is why we assess a child's brushing and readiness before starting, and why we sometimes recommend waiting a year even when the bite problem is real.
Comments