Fixing Dental Crowding (Without Extractions)

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Dental crowding describes a condition where the jaw has insufficient room for the number of teeth present. In terms of crowding of the maxilla, the condition is specific to the crowding of teeth in the upper jaw, although dental crowding can occur in either the upper or lower jaw.

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What is Crowding?

  • The presence of extra teeth.
  • The presence of teeth that have either not erupted or have only partially erupted from the gums, known as impacted teeth.
  • The early loss of primary teeth or improper tooth growth during childhood.
  • The presence of abnormally large or abnormally shaped teeth.
  • The presence of teeth that have erupted sideways, at odd angles, etc.
  • Lack of masticatory stress, or sufficient chewing, in childhood that results in a small or underdeveloped jaw.

Additionally, dental alterations may cause or contribute to the severity of crowding. These alterations are often ill-fitting, faulty or otherwise compromised, and may include, but are not limited to:

  • Crowns
  • Retainers
  • Braces
  • Appliances
  • Dental Fillings

Because the correct placement and maintenance of all dental fixtures is essential to both overall health and the prevention of overcrowding, a trusted orthodontist should always be consulted prior to any procedure. Finally, injuries, medical conditions or unhealthy habits may lead to dental crowding, including:

  • Extended use of a bottle during early childhood.
  • Pacifier use beyond 3 years of age.
  • Intensive or persistent thumb sucking or tongue thrusting throughout childhood.
  • A severe injury that results in jaw misalignment or fractures.
  • Tumors of the mouth and jaw.

 

What are the Dangers of Crowding?

Many times, patients that suffer from dental crowding are most concerned with the appearance of their smile, citing overcrowding as an unpleasant and unsightly distraction from the aesthetics of their faces. However, dental crowding is more than a visual problem and can lead to any variety of serious dental issues, including:

  • An inability to properly clean in and around the crowded teeth.
  • Ineffective or decreased teeth function.
  • An increased risk for gum disease.
  • An increased risk for tooth decay.
  • Difficulty chewing or speaking.
  • Pain or discomfort around the crowded area.

 

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Can Crowding be Fixed without Extractions?

Generally, crowding of the maxilla is addressed by tooth extraction, or the removal of one or more teeth to make room for the remaining teeth to be properly aligned. However, many patients would prefer a less invasive method of treatment. Before taking the very permanent step of tooth removal, consult your orthodontist to discuss other options, such as braces or clear aligners. Many orthodontists have the ability to keep their teeth and avoid extractions. Consult your ELOS orthodontist for their expert opinion.

 

Clear Aligners

Clear aligners are transparent, plastic dental aids that often resemble a mouthguard. Dental aligners are custom-made and use a series of 18-30 different aligners. The size varies slightly over time and changed every two weeks. This process is to gently train teeth into the desired position without the use of the more permanent hardware that braces require. These aligners can be an effective tool to combat mild cases of overcrowding when used correctly but are not recommended for more moderate to severe cases.

 

Traditional Braces

Traditional metal braces, which are comprised of metal brackets adhered to teeth with adhesive and connected with metal wires, can be an effective tool to fix tooth crowding. As the connected wires are tightened, they exert pressure on the teeth. Which, over time, can gently maneuver teeth into alignment. This type of treatment can be especially effective when teeth are crowded due to abnormal angles. Caused by improper growth, thumb sucking, tongue thrusting, pacifier or bottle use, injury, or other circumstances. However, braces do have their limits; overcrowding that is the result of an underdeveloped jaw or extra or abnormally shaped teeth may require the removal of one or more teeth before the braces can successfully correct the condition.

 

Lingual Braces

Combining many of the desirable aspects of both traditional and ceramic braces, lingual braces are metal braces that are adhered to the backs of teeth so that they are hidden from view. As with other forms of braces, these devices exert gentle pressure on misaligned, overcrowded teeth in order to straighten them. However, lingual braces are often preferred over traditional braces by patients who want to avoid unsightly metal brackets or stained ceramic fixtures. That is not to say that this variety of braces are without fault; because these braces are on the inside surface of the teeth, they can be more expensive and time-consuming to install and adjust than more traditional varieties. But they are just as successful at correcting specific overcrowding issues as their more customary counterparts.

 

 

In Conclusion on Dental Crowding

Unfortunately, there are scenarios where braces or aligners alone are simply not enough to correct the dental crowding taking place. In these instances, there may simply be too many teeth for the jaw to support, or the teeth that are present may be abnormally large or oddly shaped. In other instances, the jaw may be underdeveloped, or severely damaged due to disease or injury, and so non-surgical corrections may no longer be enough to successful realign the teeth.

 

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In such instances, tooth extractions may no longer be avoidable; however, you should always consult with your orthodontist before making any decision regarding any dental decisions. Ultimately, tooth conditions and their respective treatments must be tailored to the individual and their needs. And, while correction without tooth removal would be ideal, it is the responsibility of dental professionals to ensure the best possible treatments for your health and well-being.

Dr. Tisseront is a fine example of a lingual expert. He is also an expert on all other types of orthodontic treatment. You can find him and all other ELOS members on our website HERE.

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Fixing Dental Crowding (Without Extractions)

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