Teeth may become misaligned, overlapped, or crooked for several reasons. In some cases, the problem occurs during the developmental years when larger permanent teeth are growing into a mouth that can’t quite accommodate them yet. This can cause crowding, turning, and overlapping. Sometimes, there is a discrepancy in the size or shape of the upper and lower jaws, which can result in an overbite or underbite.
Studies indicate that misalignment may also be affected by our genetic makeup, that we can inherit crooked teeth much like we inherit eye color from one of our parents. Additional causes include the early loss of baby teeth, poorly fitting restorations, injury to the jaw, bruxism (grinding and clenching), and gingivitis. Some evidence suggests that childhood habits such as tongue thrusting or thumb-sucking may also contribute to misalignment.
It isn’t possible to change the way your teeth naturally grew. If your teeth are crooked, you can benefit from orthodontic treatment. This may be braces or it may be Clear Aligner Therapy. The treatment that is right for you depends on the severity of misalignment and malocclusion (your bite).
If your teeth are generally straight and you want to keep them that way, there are only a few steps you need to take:
Age itself does not have a strong influence over the alignment of teeth. Our teeth naturally move over time due to life influences. However, as we age, the risk of gingivitis and gum disease increases. If teeth are misaligned and difficult to cleanse, periodontal disease can occur as a complication. The gums are the soft tissue that we see around teeth. Beneath the gums are ligament and bone that hold teeth firmly in place. When gum disease occurs, it first weakens the gingiva, the uppermost layer of soft tissue. As the infection continues, it spreads deeper beneath the gingiva. The more soft tissue involvement that occurs with gum disease, the weaker the hold on teeth becomes. In advanced stages of gum disease (periodontitis), the ligament and bone degrade. This can lead to loose, shifting teeth and even tooth loss.
Bite and teeth realignment is achieved through orthodontic treatment. It is important to note, however, that no realignment or orthodontic treatment can be initiated until the periodontal clearance is obtained, and all active disease in the mouth is taken care of. Implants should also be put on hold due to the fact that they can actually impede the ideal outcome of orthodontic tooth movement.
Conventional braces straighten teeth through a series of movements made by tightening wires that span across the upper and lower arches of teeth. Clear aligner therapy straightens teeth by placing pressure on them via clear plastic trays called aligners.
The mechanism behind each method is gentle, consistent force. This force on teeth slightly loosens them from bone and the periodontal ligament. As teeth are moved by pressure, the bone gradually morphs around their new position.
Teeth straightening is not a process that we try to rush. To do so would present a risk of damaging teeth, the jawbone, or the periodontal ligament. Years of research have gone into developing the teeth-straightening methods we have today, and those that are available tend to work similarly. Working similarly means they will work in approximately the same timing. The average duration of orthodontic treatment is 6 to 24 months. How long a person has to wear braces or Clear Aligners is largely dictated by the severity of their misalignment. In terms of Clear Aligner Therapy, the duration of treatment can also be affected by the consistency with which the patient wears aligners. This system requires daily wear with removal only for meals and oral care.
The only way to straighten teeth is to move them gradually. This can be achieved with conventional braces or with Clear Aligner Therapy. The Clear Aligner Therapy system is not considered braces. The use of clear, plastic aligners is preferable to many people because aligners are nearly invisible. Patients also like having the ability to remove aligners for meals and oral hygiene.
While not intended for teeth straightening, there may also be a cosmetic option for addressing certain alignment issues. Porcelain veneers may be affixed to visible teeth to make them appear straighter or closer together if there are gaps in the smile. Veneers may be a suitable alternative for some people but should be carefully considered after a thorough consultation and conversation with an experienced dentist.
Retainers are meant to keep or retain teeth in their current position. A dentist or orthodontist will advise the use of a retainer after braces or Clear Aligner Therapy as a way of maintaining results. Retainers may be fixed or they may be removable. Your dentist will decide what type of retaining appliance makes the most sense for you and the duration and frequency of how you need to wear it.