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Adult Tooth Crowding

April 27th, 2011

Adult Tooth Crowding
It’s a fact that as we age, teeth get more crowded towards the front of the mouth.  This crowding can make it difficult to keep the teeth clean and the gums healthy.  Flossing gets more difficult and sometimes food traps form that trap bacteria, leading to decay and gum problems.
The evolutionary reason for this crowding is interesting.  Ancient peoples ate a very coarse diet and often used teeth as tools.  The enamel on the surface of the teeth abraded and the teeth wore past the widest part and down towards the gum line.  As the teeth got narrower, this drifting closed the gaps and kept the teeth together, maintaining the strength of the arch.  By age 18, so much movement had occurred that the space at the back allowed easy eruption of the 3rd molars (the wisdom teeth).  With a life expectancy of about 40, teeth lasted a lifetime.
The technical name for the phenomenon is “Physiologic Mesial Drift”, meaning that teeth drift towards the mesial or midline of the tooth arch.  Think of it as stones in the arch moving towards the keystone.  We don’t know the mechanism of how it works, but we certainly deal with the effects.  And just because you had orthodontic braces and had perfectly straight teeth in your youth does not make you immune to mesial drift as an adult.  Everyone has some tendency toward crowding but it varies from person to person as to its severity.
Treatment for crowding runs the gamut from adult orthodontic treatment and wearing retainers after treatment to just doing nothing if a disease problem doesn’t exist and esthetics aren’t a concern.  Ask your dental team to discuss your crowding.
You and your dentist can discuss options for treatment in the case of crowding that is causing a problem.  Adult orthodontics, if done at an early stage, can often be rather simple and quick.  Once the teeth are straight, you will expect to wear a retainer for the rest of your life to maintain the position of the teeth, which will naturally begin to drift again if left alone.  Retainers can be a removable clear thin plastic mouth guard type that is worn at night or a bonded wire inside the lower front teeth that stays in long term.
Often, an early diagnosis of crowding will allow you to wear a retainer without treating the crowding.  This will keep the teeth where they are, preventing further crowding but not correcting what has gone on already.  Your dental team can diagnose and suggest treatment options to prevent unsightly or disease promoting crowding.

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