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February 16th, 2012

In my last article I discussed the reason for most crowding due to physiologic mesial drift (see our web site to read the article).  What are some of the ways to correct crowding?
First, you need to decide if the situation warrants treatment at all.  Minor crowding that is not harmful to the teeth or gums and is not objectionable in appearance requires no treatment or possible a night time retainer to prevent future tooth movement.  These are simple to make and to wear and simply hold everything where it is now.
For minor crowding that only affects appearance, aligners can be made to make small movements.  Sometimes this requires “stripping” of teeth, removing small amounts of enamel from between teeth to open spaces to move the teeth into.  This won’t harm the teeth or hurt their long term health.  But to maintain the result once things are corrected, you need to continue to wear your retainers long term.
For more severe crowding the best results are obtained with conventional orthodontic treatment, full braces.  New treatment protocols include clear or tooth colored brackets and lingual braces where the brackets and wires are hidden behind the teeth.  And remember that adult orthodontics is quite common so wearing braces isn’t the unusual event that it used to be.  Once again, when treatment is complete it is imperative that yo continue to wear retainers.  Adults are even more likely to relapse than children if retainers are not worn.
When other factors such as periodontal disease are involved, a comprehensive treatment approach is needed.  Simply moving teeth without treating underlying problems with infection or tooth decay will result in a less than satisfactory outcome.  The treatment will be carefully coordinated between your general dentist, periodontist and orthodontist.

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