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Orthodontics

Early (Phase 1) Orthodontics in Frisco, TX

Phase 1 orthodontics in Frisco helps a specific and fairly small group of children. For most, the honest answer is to watch, and that watching is itself a real, considered choice.

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Or call (469) 262-2111
Assessed around 7assessed, which is not the same as treated
Two routesstraight-wire appliances, or Invisalign First
Class III referredincluding in early treatment
Watching is a planand it is the right one for most children
The process

What early (Phase 1) orthodontics can and cannot do

The case for early treatment, around age eight, rests on growth. Where growth is the mechanism, timing genuinely matters. Where it is not, waiting usually costs nothing.

  1. Crossbites: the strongest case for early treatment

    A crossbite applies sideways force to teeth not built for it. In a growing child, it can cause the lower jaw to shift to one side to find a comfortable bite. Correcting it while the palate is still developing is more straightforward than correcting it afterwards. If there is one clear argument for early treatment, this is it.

  2. Significant overjet: protecting the front teeth

    Upper front teeth that stick out well ahead of the lower ones are considerably more likely to be broken in a fall or a knock. And children fall. Reducing that risk is a real reason to treat before the teenage years. It is a safety argument as much as a cosmetic one.

  3. Severe crowding and lack of space

    Where the arch is clearly too small for the teeth that are coming, creating space early can reduce what is needed later — and occasionally avoid extractions. "Occasionally" is the honest word. It does not always.

  4. Habits that are moving teeth

    Thumb or dummy habits continuing once the adult front teeth are through can push them forward. Where gentler approaches have had a fair try and it has genuinely persisted, an appliance works well at that point.

  5. When we refer to an orthodontist

    Class III cases, where the lower jaw sits forward, are referred to an orthodontist, including in early treatment. That is a skeletal problem and specialist work, handled by the orthodontist we refer to.

  6. For most children, we watch and review growth

    Records, a scan, and a plan to review it — at recall visits you were coming to anyway. Where growth is the question, those records include a cephalometric: a side-on X-ray taken to a fixed geometry. That way the same measurement can be directly compared two years later, with no re-estimating needed. That is what turns watching into a plan. Most bites that look alarming at eight resolve or become straightforward at twelve. Treating them twice costs more, takes longer, and asks a great deal of a child.

Good to know

Phase 1 orthodontics: what parents should know

Why we are cautious about two phases

Early treatment is genuinely valuable for a small group of children. It is also, across the profession, recommended more often than the evidence comfortably supports. The uncomfortable version: for many problems, two phases of treatment produce a result no better than one phase started at twelve. And it costs more, takes far longer, and asks more of a child's patience. Research comparing early treatment of prominent front teeth against a single later course has repeatedly found similar end results. The real exception is a reduced risk of trauma in the meantime, which is a legitimate reason on its own. So our position is narrow. Treat early where growth is the mechanism and timing genuinely matters: crossbites, significant overjet, habits that are actively moving teeth, and severe space problems. Watch everything else. And where we recommend watching, that is a plan with review appointments — not a way of saying no. Two of the teenage cases in our smile gallery show what that looks like when it works. Both had the makings of a two-phase case, and both were treated as a single course instead, at eighteen months and two years.

A chairside monitor showing a child's teeth from the front, a mixture of baby and adult teeth in the arch.

Straight wire braces or Invisalign First

Both are available here for early treatment and they suit different children. Fixed straight-wire appliances do not depend on cooperation, which for a seven-year-old is a genuine advantage. They work whether or not anyone remembers. Invisalign First is the aligner system designed for the mixed dentition. It accounts for teeth still erupting and jaws still growing, and it avoids brackets and wires entirely. It depends on wear time, which for a young child depends on a parent as much as the child. The right choice is about the specific problem being corrected. It is also about your family honestly assessing whether the wear time will happen. There is no premium option here and no reason to choose one for appearance; we will tell you which suits the case.

A small clear aligner beside a plaster model carrying a fixed wire appliance across the front teeth.

Early (Phase 1) Orthodontics near Frisco, Prosper and Plano

Children's bite assessments are done at our office at 8175 Custer Rd, Suite A110, Frisco, TX 75035, where Dr. Peravali looks at your child's bite with records and tells you whether it is a treat-now, watch-and-review or specialist case. We are open Monday, Tuesday, Thursday and Friday from 9 AM to 6 PM and Saturday from 9 AM to 3 PM. Wednesday and Sunday we are closed, though the phone is still answered on Wednesday. Families come from Frisco and from Prosper, Plano, Little Elm, Allen, Celina and McKinney.

Call (469) 262-2111

Two cases that could have been treated in two phases

Both had the indications for early treatment. Both were watched and then treated once, in the permanent teeth.

  • Before treatment at White Lotus Dental, Frisco TX — Crowded teeth, inflamed gums that bled, food trapping between the teeth, and real difficulty keeping them clean.
    Before
    After treatment at White Lotus Dental, Frisco TX — Invisalign, treated while the patient was still growing — the arches were widened and the crowding relieved. Conventionally this would have been split into two phases of treatment; it was done as one.
    After
    Came in with
    Crowded teeth, inflamed gums that bled, food trapping between the teeth, and real difficulty keeping them clean.
    What we did
    Invisalign, treated while the patient was still growing — the arches were widened and the crowding relieved. Conventionally this would have been split into two phases of treatment; it was done as one.
    Time in treatment
    2 years
  • Before treatment at White Lotus Dental, Frisco TX — Narrow arches, crowding and inflamed gums.
    Before
    After treatment at White Lotus Dental, Frisco TX — Invisalign, treated while the patient was still growing — the arches were widened, the teeth straightened and the bite corrected. Conventionally a two-phase case; it was done as one.
    After
    Came in with
    Narrow arches, crowding and inflamed gums.
    What we did
    Invisalign, treated while the patient was still growing — the arches were widened, the teeth straightened and the bite corrected. Conventionally a two-phase case; it was done as one.
    Time in treatment
    18 months

Orthodontic treatment for a growing child is often split into two courses — an early phase to make room, a pause while the adult teeth arrive, then a second phase to finish — with each phase quoted separately. Both teenage cases here had the makings of that. They were treated as one continuous course instead, which is why they ran eighteen months and two years: longer than a single phase, and less than two.

Every case on this page was treated in this office, by our own doctors. These are photographs of our own patients, published with their permission. They are close-up photographs of teeth — not portraits of faces — so no patient can be identified from them, which is exactly why patients were willing to let us show them.

Choosing between options

Treat now, or wait?

The honest split, problem by problem.

Comparison of Treat early, Usually wait
FeatureTreat earlyUsually wait
CrossbiteYes — the strongest case—
Significant overjetOften, mainly for trauma risk—
Habit still moving teethYes, after gentler approaches—
Severe crowding or space lossSometimesOften fine to wait
Mild or moderate crowding—Wait — it is often simpler at 12
Deep bite, no damage—Wait
Appearance of the front teeth—Wait, unless trauma risk is real
Class III—Referred to an orthodontist
In depth

Early orthodontic treatment is worth doing for some children, and it is recommended more widely than the evidence supports. Three questions separate the two.

1. “What specifically are we correcting, and what happens if we wait?”

A strong answer names the problem and the cost of waiting — this crossbite is shifting her jaw to one side, these front teeth are prominent enough to be at real risk in a fall. A weaker answer is about crowding that will still be there at twelve.

2. “Will this avoid braces later, or make them simpler?”

“Avoid” is very often overpromised. “Make simpler” or “prevent a specific harm” is usually the truthful version, and it may still be a good reason.

3. “What is the total cost of both phases, and how much of the lifetime insurance benefit will Phase 1 use?”

Ask this before the first appliance goes on — it is the single most common financial surprise in children’s orthodontics.

We will answer all three. For most children, our answer to the first one is that there is nothing yet that waiting would cost you.

Related reading: space maintainers and habits covers baby-tooth loss and thumb or dummy habits, bite problems explained shows which bites need treating, and children’s dentistry describes how we care for younger patients.

To book a children’s bite assessment in Frisco, call (469) 262-2111 or request an appointment online.

Planning your day

Time in the chair for early treatment.

In the chair
45 min to 1 hr
Appointments
One visit
Start to finish
9 to 12 months for Phase 1
Who does it
Dr. Peravali

What moves it: Followed by a resting period and, often, Phase 2 treatment in the teen years.

This is a booked range. It isn't a stopwatch. It covers being seated, numbed where that is needed, and the treatment itself — and we would rather run to the top of the range than rush the end of it.

Cost & insurance

Phase 1 orthodontics cost in Frisco: what to expect

The lifetime maximum matters here mostOrthodontic insurance benefits are usually a lifetime maximum, used once across all treatment. If Phase 1 uses most of it at eight, there may be little left for comprehensive treatment at thirteen. Know the whole plan and the whole cost before the first appliance goes in.
Two phases cost more than oneNot always double, and always more. That is a real part of the decision, and it should be stated clearly up front. It is why we treat early only where there is a clinical reason that waiting would forfeit.
Watching is inexpensiveReview at recall visits you were attending anyway, with records taken when there is something to record. It is the cheapest orthodontic plan there is and the right one for most children.
Medicaid orthodonticsOrthodontics under Medicaid is referred out to a specialist — see our page on Medicaid, CHIP and braces for how the medical-necessity standard actually works.

You get the figure in writing before treatment starts. We accept all major PPO plans and file the claim for you, our membership plan takes a percentage off treatment, and CareCredit financing is available.

Book a consultationCall (469) 262-2111
Using your insurance

How plans usually cover early treatment.

Orthodontics — its own category, with its own ceiling

What plans pay
Commonly 50%, up to a separate lifetime maximum of around $1,000 to $2,000. Read that again: this is a lifetime maximum. It does not reset every year the way the annual one does.
Deductible
Often a separate one-off orthodontic deductible, and on some plans none at all.

What catches people out

  • Age limits. A great many plans cover orthodontics only up to age 19, some only to 18. Adult orthodontic coverage exists but it is much less common than people expect.
  • A lifetime maximum does not come back. Once it is spent it is spent, on that plan and any future one that counts prior treatment — which is why a second course of treatment is usually paid entirely by the patient.
  • Benefits are paid in instalments across treatment — not up front — so changing employer mid-treatment can stop the payments partway through.
  • Early treatment can spend the lifetime benefit. Some plans treat a phase one course and later full treatment as two separate claims against one lifetime maximum. And a few will not pay for early treatment at all. It is the single most useful thing to check before starting.

These are how dental plans usually classify this treatment — not a statement about your own plan. Yours is the one that governs, plans differ more than people expect, and the only reliable answer comes from reading your specific benefits, which we always do ahead of treatment and give you in writing.

And what changes out-of-network

A dentist who is in-network has signed a contract fixing what may be charged for each procedure and cannot bill you the difference. One who is out-of-network has signed nothing, so the full fee stands.

So the first difference is the price itself — the same treatment is simply allowed to cost more out-of-network, before anyone's plan is considered.

What you personally pay out of that depends on your own deductible and coinsurance, which is why there is no percentage here: it is not a property of the treatment, it is a property of your plan, and we verify yours before you commit. But two things follow for everybody. Your share is a share of a bigger number. And your orthodontic lifetime maximum is spent by what the plan pays toward that bigger number, so the same treatment eats more of your benefit out-of-network. That pot does not reset, which is what makes it bite.

An illustration, not a quote. Both allowed fees for early treatment are not yet on hand, so the chart above shows a crown instead — the one procedure we hold both sides for. The in-network side is today's contracted allowance; the out-of-network side is what a single carrier allowed during a period when we were not contracted with it, and it is a few years old. Across the 23 procedures where we hold both allowed fees, out-of-network is between 1.2 and 5 times the in-network figure — most often a little over twice.

Check the going rate yourself

FAIR Health's dental cost lookup is free, needs no account, and is not ours — it reports what a procedure typically costs in your area. It does not know your plan, so treat it as a ballpark figure — not a final answer.

Ask us for the number first

We verify your specific plan before your appointment and give you a written estimate: what the plan is expected to pay, and what you pay. If we get it wrong we tell you why.

Bring an Explanation of Benefits

Treated somewhere else? Your EOB shows exactly what the plan paid and what it counted against your maximum. Bring one in and we will read it with you — whether or not you become a patient here.

None of this says out-of-network dentists are worse dentists. Plenty are excellent, plenty are out-of-network for sound reasons, and people choose a dentist for who that person is. What we think you are owed is the information, so that whatever you choose, you chose it knowingly. The whole thing, explained properly, or call (469) 262-2111 and ask.

Getting here

Booking early (phase 1) orthodontics in Frisco

Book an appointmentCall (469) 262-2111
Hours
Weekdays 9–6
Saturdays 9–3
Languages
English, Telugu, Hindi, Urdu
Arabic with Saba, our hygienist, Tuesdays, Thursdays and Fridays
Vietnamese with Anh, our hygienist, Saturdays
Cantonese and Mandarin with Dr. Louie, our periodontist, on his scheduled days, by internal referral
Also serving
McKinneyPlanoProsperLittle ElmAllenCelina
Before you call

Questions Frisco parents ask about early (Phase 1) orthodontics

Grouped so you can go straight to the one you came for.

Early (Phase 1) Orthodontics — common questions

At what age should my child see someone about their bite?
Around age seven is the usual recommendation. By then the first adult molars and front teeth are through, so the few problems where early treatment helps can be found while timing still matters. Being assessed at seven is not the same as being treated at seven. For most children the outcome is a plan to watch.
Does my child actually need Phase 1 treatment?
Probably not, which is the honest answer for most children. Early treatment is clearly worthwhile for crossbites, for significant overjet where front teeth risk being broken, for habits still moving teeth, and for severe space problems. For most other bites, a single course at around twelve gives an equivalent result with less time, cost and effort.
What is Invisalign First?
It is the aligner system designed for children with a mix of baby and adult teeth. We offer it alongside conventional straight-wire appliances. Fixed appliances do not depend on cooperation. Aligners avoid brackets and wires but need real wear time, which for a young child depends on a parent as much as on them.
Will early treatment mean my child avoids braces later?
Sometimes, but often not, and any practice promising it is overpromising. Phase 1 addresses a specific problem while growth can help, and aligning all the adult teeth usually still follows in the teenage years. It is more honest to think of early treatment as making the later course simpler or preventing a specific harm.
Do you treat all early cases here?
No. Class III cases, where the lower jaw sits forward of the upper, are referred to an orthodontist, including in early treatment. That is a skeletal relationship and not a tooth-position problem, and it is specialist work. We would rather tell you at the assessment than a year into something that was not going to work.
How does insurance work for two phases?
Orthodontic benefits are typically a lifetime maximum, not an annual one: a single figure that does not reset. Using most of it on Phase 1 at eight can leave little for comprehensive treatment at thirteen. That is not an argument against early treatment where it is indicated, but it is a reason to know the whole plan first.
What does watching actually involve?
Records now, meaning a scan, photographs and the relevant X-rays, then a review at the recall visits your child already attends. Where growth is the question, the records include a cephalometric, a side-on X-ray taken to a fixed geometry so the same measurement can be compared later. It costs very little, and it is a plan, not a refusal.
How will you know when the right moment to treat has arrived?
Partly from what the teeth are doing and partly from measurement. Where timing depends on growth, a cephalometric taken at the assessment gives a baseline, and the same image repeated later shows whether your child is still growing. For most children the trigger is simpler: the adult teeth arrive, and a single course at around twelve does the job.
Do you take Medicaid for orthodontics?
No. We accept Medicaid and CHIP for children's dental care but not for orthodontic treatment, and we refer those families out. Texas Medicaid covers braces only where a case meets a strict medical-necessity standard, which surprises many families — our page on Medicaid, CHIP and braces explains how it works and where to go.
What age should a child get phase 1 braces?
The American Association of Orthodontists recommends a first check around age seven. Where early treatment is justified, it typically happens around age eight, while growth can help. Most children are not treated then: they are watched and, if needed, treated once at around twelve. An exam tells us which group your child is in.
What does a palate expander do?
A palate expander sits in the roof of the mouth and gradually widens a narrow upper jaw, making room for teeth and helping correct a crossbite. It is often used around age seven or eight, while the jaw is still growing. If an exam suggests it, we explain the options and whether we treat it here or refer it out.
What is phase 1 treatment in orthodontics?
Phase 1 is early orthodontic treatment, started while a child is still growing, to guide the jaws or correct a problem that waiting would make harder. Most children do not need it. We watch growth at recall visits and treat early only where there is a clinical reason that waiting would forfeit.
How much does phase 1 orthodontics cost?
Two phases cost more than one, not always double, and always more, so we say so up front. Many plans have a lifetime orthodontic maximum that early treatment may use, leaving little for later. Watching is the cheapest plan and right for most children. We quote the whole plan in writing first.
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