Hear NESO2018 Speaker Neal Kravitz on A Return to Phase I Efficiency

Neal D Kravitz, DMD, MS

Phase I interceptive treatment should be prescribed conservatively. In many offices, virtually every second or third grader entering for a consultation now leaves with a treatment plan for an expander and braces. When I started my practice, I was no different. I used to tell parents that the expander would obviate the need for extractions and that the braces would help the maxillary canines safely erupt. I would pitch to them that all of this effort would save time and effort when the patient was ready for comprehensive treatment. In actuality, some of these patients received very little benefit from Phase I, and they still required two years of comprehensive treatment with appliances or extractions. 

 I now selectively recommend Phase I treatment, and prefer to solely use an appliance (i.e. expander, space maintainer, bite plate) when possible. If the patient has an anterior dental crossbite in addition to their severe transverse constriction, whip springs are then added to the expander to provide incisor alignment.  Patients with moderate crowding in the absence of a crossbite are referred for extractions of their deciduous canines instead. My Phase I treatment is now streamlined and focused. 

 I strive to complete Phase I treatment within 12 months. The parents understand the specific goals of treatment, but I still ask them to sign a consent form titled “Phase I means Phase 2,” so there is no misremembering that a separate phase with brackets will happen years later. If the patient displays severe crowding in the early mixed dentition (the indicators will be discussed in the lecture), then I typically prescribe serial extraction and place the patient on a recall. I am of the opinion that we may be overtreating our young patients. What we call interceptive is sometimes just interference.

This lecture focuses on improving Phase I Efficiency.  Discover Dr. Kravitz’s philosophies on common Phase I problems and pick up a few clinical pearls along the way! View Full Speaker Schedule Here!


1.     Discover Phase I treatment pearls

2.     Learn Phase I retention strategies 

3.     Review Dr. Kravitz’s protocol for common problems

Bio: Dr. Kravitz is a Diplomat of the American Board of Orthodontics, member of the Edward Angle Honor Society, and Associate Editor for the Journal of Clinical Orthodontics.  Dr. Kravitz is a graduate of Columbia University and received his D.M.D. and the University of Pennsylvania. He is also a prolific writer for numerous journals.  Dr. Kravitz lectures throughout the country and internationally on treatment planning, biomechanics, practice management, and ethics.