Phase 1 Orthodontics in New Orleans: Early Treatment That Knows When to Wait

Medically reviewed by Dr. Allison Hamada. Last updated June 2026.

Most parents across the New Orleans area who book an early evaluation with us these days didn’t come because a dentist sent them. They came because they saw a reel about mouth breathing, read something about jaw development, or watched a friend’s kid get a palate expander and started wondering about their own. They’re paying attention to how their child breathes and sleeps, and they aren’t waiting for a referral to start asking questions.

That instinct is a good one, and it deserves a real answer instead of a sales pitch. If you’re looking into Phase 1 orthodontics in the New Orleans area, Dr. Allison Hamada will tell you honestly whether your child needs early treatment while they’re still growing, or whether the smarter call is simply to watch and check back. A lot of children who come in don’t need anything yet, and you deserve to hear that plainly.

What Phase 1 orthodontics actually means

Phase 1, also called early or interceptive treatment, is a short, focused round of orthodontic care for children who still have a mix of baby teeth and adult teeth, usually somewhere around ages six to ten. The goal is not a finished, photo-ready smile right away.

The goal is narrower than that. Phase 1 addresses one or two specific developing problems while your child is still growing, so those problems don’t turn into bigger, harder ones later. Think of it as guiding the jaw and making room while the bones are still soft and cooperative, rather than forcing things into place after everything has set.

Here is where Dr. Hamada’s view differs from the way Phase 1 often gets described. She isn’t looking only for crooked teeth to straighten. She’s watching how the jaw and airway are developing, and she’s seeing more and more children whose jaws and airways are growing too small. A narrow jaw and a restricted airway are easy to miss, because they show up in ways most parents would never connect to orthodontics: trouble focusing, restless sleep, the kind of fidgety, can’t-sit-still behavior that often gets labeled an attention problem. We go deep on that link in our mouth breathing and ADHD article. The growth window is exactly when those things are easiest to guide.

None of that means every child needs treatment, and Dr. Hamada doesn’t push kids into Phase 1 who don’t need it. It means she’s looking at more than whether the front teeth are straight. When a child does need early guidance, getting the timing right can shorten or simplify whatever comes later, and in some cases head off tooth extractions or jaw surgery. When a child doesn’t, she’ll tell you that too. Phase 1 is one piece of two-phase treatment, and not every child who has a first phase will need a second.

Why you keep hearing “age 7,” and why it isn’t a deadline

Here is the thing we’d rather you watch instead of a birthday: the everyday signs. Snoring that won’t settle, breathing through the mouth instead of the nose, restless sleep, teeth grinding, a bite that looks a little off to you. When airway and jaw development are involved, waiting isn’t neutral, and those signs are reason enough to come in at any age.

The American Association of Orthodontists does recommend a first orthodontic check by age seven, and that guideline is useful, but it trips parents up because it sounds like a recommendation for braces at seven. It isn’t. By age seven, enough adult teeth and jaw growth have arrived that Dr. Hamada can spot developing problems early: a narrow upper jaw, a crossbite, severe crowding, a bite drifting the wrong way. Spotting something early is not the same as treating it early. It just means she can tell you whether to act now, keep an eye on it, or stop worrying about it.

So treat age seven as a default checkpoint, not a gate. It’s the age the AAO lands on when nothing has obviously come up. If you’ve already noticed something, you don’t have to wait for a birthday or a referral. Dr. Hamada is glad to take an early look at six, or sooner when something clearly needs attention.

Where your child’s breathing comes into it

This is where our exams look a little different from a standard orthodontic visit. Dr. Hamada doesn’t only look at how the teeth line up. She looks at how your child breathes, because the two develop together. A narrow upper jaw, a low tongue posture, or a habit of breathing through the mouth can shape how a child’s face and bite form, and it can affect sleep, focus, and mood along the way.

One boundary worth stating up front: this is an orthodontic look at jaw and airway development, not a diagnosis or treatment of sleep apnea. That’s a medical question for a physician. What Dr. Hamada can identify is whether a skeletal or jaw issue may be a contributing factor to breathing problems, and when the breathing question calls for a medical answer, she points families toward a physician or ENT. When tongue posture, oral habits, or muscle function are part of the picture, she works alongside myofunctional therapists like Bloom Therapy Group, a New Orleans practice that handles that side of care, rather than treating the jaw in isolation.

That airway lens is on every exam, not a separate service you have to ask for. It’s simply part of what makes the evaluation thorough. Some of the same early appliances that make room for adult teeth, like a palatal expander, can also widen a narrow arch and make breathing through the nose easier in the process.

For Dr. Hamada, this started at home before it ever became how she practices. When her own daughter, Sophia, was young, she watched her struggle with the kind of breathing and sleep issues that an underdeveloped jaw can drive. Seeing it up close, in her own child, is what pushed her to build airway screening into every exam. You can read more about that side of the practice on our airway orthodontics page.

The everyday signs worth an early look

Most parents don’t notice orthodontic problems in clinical terms. They notice small things that seem a little off. None of the signs below means your child needs treatment, but each one is worth a look while the jaw is still developing and a problem is easier to guide:

These are the things Dr. Hamada looks at during an early visit. Sometimes they point to an issue worth addressing during this growth window. Often they turn out to be a normal part of a child still working through a mix of baby and adult teeth.

Either way, you leave knowing. If you’ve noticed your child breathing through their mouth more than seems normal, that alone is worth a conversation.

“Is this just a way to sell my kid braces?”

You’re protective of your child and protective of your wallet, and the internet is full of stories about families who felt pushed into expensive treatment by high-volume clinics that treat patients like line items. Those stories are real, and the skepticism is fair.

Here’s how we work instead. Dr. Hamada completed her dental training at LSU School of Dentistry and her orthodontic residency at Columbia University, and she’s been practicing since 2004. She examines your child herself at the visit. Not an assistant, not a coordinator with a script. She looks at the teeth, the bite, and the airway, explains what she sees in plain language, and gives you an honest recommendation.

If your child needs early treatment, she’ll tell you exactly why and what it will accomplish before you commit to anything. If your child doesn’t need it, she’ll say so, and you can go home and let your kid be a kid. And if you’ve had a recommendation somewhere else and want a second set of eyes, that’s a completely reasonable thing to want. A practice that stands behind its recommendations has no reason to mind one.

Dr. Hamada truly knows exactly what she’s doing. She doesn’t talk over your head, she takes the time to explain things in a way you can actually understand. She provided valuable insight into why my son was sleepwalking and explained how the tongue plays a major role. Both of my sons received palate expanders. Most importantly, my younger son has not been sleepwalking since. Anytime we needed them or had questions, they were always quick to text or call us back, which meant so much to us.

K

Kenny

Verified Google review

What Phase 1 treatment can involve

Phase 1 is targeted, not all-encompassing. A lot of parents call it “Phase 1 braces,” and sometimes it does involve braces. Just as often it’s a palatal expander, a space maintainer, or a small appliance to ease a habit, depending on what your child actually needs.

When Dr. Hamada does recommend treatment, one of the most common appliances is a palatal expander, sometimes paired with a short course of partial braces to handle a specific issue. The expander is a custom appliance that gently widens a narrow upper jaw over a few weeks, making room for adult teeth, correcting crossbites, and often easing nose breathing along the way. When we do use braces, we work with the Pitts21 bracket system, which applies lighter forces for more comfortable treatment. Kids tend to adjust faster than their parents expect, and the brief pressure after each adjustment passes quickly.

The situations Phase 1 is most useful for include:

• A narrow upper jaw or crossbite, where the top and bottom teeth don’t meet correctly
• Significant crowding, where there’s clearly not enough room for the adult teeth on the way in
• An open bite, often tied to thumb sucking or a tongue-thrust habit
• A protruding or deep bite with a skeletal component, where guiding jaw growth early makes a real difference
• Early loss of baby teeth, where holding the space open keeps the other teeth from drifting

Every child is different, which is why none of this gets decided from a webpage. It gets decided after Dr. Hamada actually looks in your child’s mouth. You can read more about how we approach growth and jaw development in kids.

Does my child need a palate expander?

A child may be a candidate for a palate expander when the upper jaw is too narrow, when there is a crossbite, or when there isn’t enough room for the adult teeth coming in. It’s one of the most common Phase 1 appliances, though plenty of children who need early treatment never get one. Only an exam can say for sure.

A palate expander gently widens a narrow upper jaw over a few weeks, while the bones of the palate are still separated and easy to guide. That added width does a few things at once. It makes room for crowded adult teeth, it can correct a crossbite where the upper and lower teeth meet incorrectly, and in many children it opens the nasal passages enough to make nose breathing easier. Because expansion works alongside active growth, it’s most effective during the mixed-dentition years, while your child still has a blend of baby and adult teeth.

It isn’t the right tool for every child, and a narrow smile on its own doesn’t automatically call for one. Persistent mouth breathing, a crossbite, or significant crowding are the developing bite problems that more often point toward expansion. Dr. Hamada recommends an expander only when your child’s growth and bite genuinely call for it, and she’ll walk you through exactly why if she does.

The honest answer to whether your child needs an expander, braces, or nothing yet comes from an exam, not a webpage. That’s what the first visit is for.

Why timing matters, for the kids who need it

For the children who do need early treatment, the reason timing matters comes down to one thing: some problems are far easier to correct while the jaw is still growing. Here’s what the growth window changes.

None of this means every child should start now. It means that for the specific problems that depend on growth, waiting past the window can turn a simple fix into a major one. An exam is what tells us which kind of problem your child has, if any.

The children who can safely wait

Some children genuinely can wait, and recognizing them matters just as much as catching the ones who shouldn’t. Early treatment usually isn’t the right call when a child has mild crowding that can be handled later, a minor bite issue with no skeletal component, or simply teeth that look a little crooked while everything is still developing normally. Crooked baby teeth on their own are rarely a reason to start.

In those cases, the smarter and less expensive path is to do nothing yet and watch. That’s the point of regular growth checks: if a problem starts to develop, you catch it at the right moment, and if it never does, you haven’t spent years chasing treatment your child didn’t need. Doing less, when less is the right answer, is part of honest orthodontic care.

Treat now, or watch and wait

The real decision parents face usually isn’t “braces or no braces.” It’s “treat now, or wait and watch.” Here’s the honest version of how that call gets made.

Only an exam tells you which column your child is in, and that’s the whole reason to come in. Dr. Hamada will put your child in the honest column, not the profitable one.

What comes after Phase 1: the resting period

This is the part a lot of practices skip past, so let’s be upfront. Phase 1 doesn’t usually replace later treatment. After the early appliance does its job, your child enters a resting period while the rest of the permanent teeth come in. Many children will still need a Phase 2 round of braces or aligners in their teen years to finish the alignment.

So why do Phase 1 at all? Because the early work handles the hard, growth-dependent problems while the window is open, which usually makes that later phase shorter and simpler than it would have been. A skeletal issue that’s straightforward to guide at age eight can become a much bigger project, sometimes a surgical one, if it waits until growth is finished.

During the resting period, Dr. Hamada keeps an eye on your child’s bite at regular intervals, so Phase 2 starts at exactly the right moment. Not too early, not too late. You aren’t paying for a holding pattern, and you aren’t left guessing about timing.

What early treatment costs

Because Phase 1 is focused and time-limited rather than a full course of treatment, it usually costs less than a complete set of braces. The exact figure depends on which appliance your child needs and how involved the correction is, which is why we give you a real number at the consultation instead of a vague range online.

Insurance often covers a portion of orthodontic treatment for children, though coverage varies a lot from plan to plan, so we go over your specific benefits with you at the complimentary visit. You’ll see a clear breakdown of what your plan covers and what flexible payment options are available, with the full picture in front of you before you decide anything. If you want to understand the bigger cost picture first, here’s what orthodontic treatment costs in the New Orleans area.

What your child’s first visit looks like

The first visit is complimentary, unhurried, and built to answer your questions rather than push you toward anything. Here’s how it goes:

You can read more about what to expect at your first visit, but the short version is that you’ll leave understanding exactly where your child stands.

What we take off your plate

This is a big decision, and we don’t treat it like a small one. When you bring your child in, you’re handing us someone who matters to you more than anything, and we hold that carefully. We explain things to your child in words they actually understand, we keep the visit unhurried, and we look after your child the way we’d want someone looking after our own.

We make the parent’s part easier too. You don’t have to become an expert in growth windows or lie awake wondering whether you’re missing the right moment to act. That’s our job, not yours. We watch the timing for you, we walk you through insurance and costs at the complimentary visit so you’re not decoding it alone, and we tell you plainly what to do next and what to skip. You get to leave knowing the plan, knowing the cost, and knowing your child is in steady hands.

Why families across the New Orleans area choose Hamada Orthodontics

Choosing who guides your child’s care is a bigger decision than choosing where to get teeth straightened. You want someone you trust, and an experience that doesn’t feel like a factory.

More and more, families are making a real drive to see us, some from as far as Baton Rouge, often passing other orthodontists on the way. They come because of what they’ve heard from family and friends, and we don’t take that lightly. It’s the kind of trust you only earn one patient at a time. What we’re really after is simple: a parent who can lay their head down at night without second-guessing, knowing they made the call that’s going to shape their child’s future.

Dr. Hamada sees your child herself at every step, and her airway-focused approach means she’s looking at the whole picture of how your child grows and breathes, not just whether the front teeth are straight. With three offices in Metairie, Luling, and Destrehan, serving families across Jefferson and St. Charles parishes, there’s a good chance we’re already treating children in your community, and a short drive to a familiar face.

Phase 1 orthodontics: common questions

Does my child really need Phase 1, or can we wait?

The only way to know is an evaluation, because the answer is different for every child. Dr. Hamada examines your child’s teeth, bite, and airway, then tells you honestly whether early guidance would help and explains why. If waiting is the smarter call, she’ll say so. If something needs attention during the growth window, she’ll explain that too.

Is my seven-year-old too young for braces?

A check at seven doesn’t mean braces at seven. The age-seven recommendation from the American Association of Orthodontists exists so an orthodontist can spot developing problems early, not so every child starts treatment that young. Most seven-year-olds who come in are simply watched over time.

What age is too late for Phase 1 orthodontics?

Phase 1 works because the jaw is still growing, so the window is roughly the mixed-dentition years, around ages six to ten. Once the upper jaw’s growth plate starts to fuse in the early teens, a few corrections that were simple early on need a different approach. That doesn’t mean your child missed out on orthodontics. Treatment is still very doable later, it just may look different. If you’re not sure where your child falls, an early visit will tell you.

How long does Phase 1 treatment take?

Phase 1 is a short, focused course of treatment, not a multi-year process. Most early treatment runs somewhere between a few months and about a year and a half, depending on what’s being corrected, and it usually wraps up well before a child would otherwise start full braces. Dr. Hamada will give you a clear timeline at your consultation before anything begins.

Can a palatal expander help my child breathe better?

For some kids, yes. Widening a narrow upper jaw can open up the nasal passages and make breathing through the nose easier, which is part of why Dr. Hamada looks at the airway alongside the bite. It isn’t a guaranteed fix for every breathing problem, and it isn’t the right move for every child, which is what the evaluation sorts out.

How does the airway piece fit into early treatment?

Breathing and jaw growth are closely linked, so Dr. Hamada looks at how your child breathes as part of every early evaluation. A narrow upper jaw or persistent mouth breathing can affect sleep, focus, and the way the face develops. When one of those shows up, addressing it during the growth window is often easier and more effective. To be clear, this is an orthodontic evaluation of jaw and airway development, not a diagnosis or treatment of sleep apnea, which is a medical matter for a physician.

Can early treatment prevent tooth extractions or surgery?

Sometimes, for certain problems. When a bite issue has a skeletal component, guiding the jaw while your child is still growing can lower the odds of needing extractions or, less often, surgery later on. It isn’t a guarantee, and it only applies to specific cases, which is exactly what Dr. Hamada weighs at the visit. For many kids, the honest answer is that no major intervention was ever going to be needed.

Will my child still need braces after Phase 1?

Often, yes. Phase 1 handles specific growth-related problems early, and a second round of braces or aligners usually follows once all the permanent teeth are in. The upside is that the early work tends to make that second phase shorter and simpler.

Does Phase 1 treatment hurt?

Children usually feel mild pressure or soreness for a few days after an appliance is placed or adjusted, easily managed with over-the-counter children’s pain relief. With an expander, the pressure right after each adjustment lasts only a moment. Kids adapt faster than parents expect.

Should I get a second opinion?

Absolutely, if you want one. If a recommendation anywhere feels rushed, oversized, or unclear, a second opinion is a smart step, and Dr. Hamada welcomes families coming in for a fresh look.

About Dr. Allison Hamada

LSU School of Dentistry · Columbia University orthodontic residency · Practicing since 2004

Dr. Hamada trained at LSU School of Dentistry and completed her orthodontic residency at Columbia University, one of a small number of programs known for the depth of its training in complex bite and jaw cases. Her airway-focused approach grew out of her own family’s experience, and today every exam she performs includes a look at jaw development and breathing alongside the bite.

Read more about Dr. Hamada

Recommended by a fellow physician

My daughter needed maxillary expansion, and the difference it has made in her dental crowding as well as her breathing and snoring has been easily evident. Dr. Hamada utilizes new systems for expansion and bracketing, which were so much easier and more effective than older orthodontic systems. I would definitely recommend her.

E

Emily B.

ENT physician · Google review

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The first step is simple and complimentary: a thorough look from Dr. Hamada, a clear explanation of what she finds, and a straight answer about whether early treatment makes sense for your child right now.

Allison Hamada

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