Crooked Teeth

Crooked teeth are a problem for millions of people. People live their whole lives with some minor crooked teeth, but if crooked teeth cause problems with health, chewing comfort, and spoil a person’s appearance, it can and should be treated.

Crooked teeth are common in children and adults. They embarrass ordinary people, but even more so for celebrities who appear in public, movies and glossy magazines. Fortunately, getting your teeth fixed is no longer a problem. The orthodontist’s office will make it perfect.

Causes

Crooked teeth can occur at any age. Even a breastfed baby can be harmed by an incorrectly selected pacifier. True, the front milk teeth will eventually fall out and be replaced by permanent teeth. Since then they need to be watched better – don’t put foreign objects in your mouth and avoid the habit of pressing on the crown with anything.

Crooked Teeth

While the baby teeth are still growing, they are especially sensitive. The crown is shaped properly in contact with neighboring teeth, including those that are on the opposite side of the jaw. But excessive clenching, grinding of teeth, and regular tongue pressure all have a negative impact on the formation of teeth. It is harmful to chew nails, to suck on fingers or a pencil, or to chew sunflower seeds, as children sometimes do.

Smoking, especially of pipes or cigarettes with a hard mouthpiece, contributes to the crookedness of already formed teeth in people even of advanced age. Toothbrushes should be changed in time. A new toothbrush with a hard bristle brush is less damaging to your bite because a soft one presses harder against your teeth.

But even perfect oral care doesn’t help many people. Teeth don’t grow correctly because they are genetically programmed to do so. They are similar to ancestral teeth. If parents and grandparents had hereditary irregularities, children and grandchildren will have them. Most often there are genetic variations of wisdom teeth, the last ones on the jaws. They may not exist at all, but if the “eight” begin to erupt on relatively small jaws from nature, where there is simply not enough room, they are certain to warp or remain underdeveloped.

Tooth growth is also affected by acquired diseases. Fetal abnormalities, rickets in infancy, and chronic infections can impair the development of dental rudiments. Already rare scurvy (vitamin C deficiency) leads to loose teeth, and they take an unpredictable position.

But the most destructive effect on the bite is the absence of some teeth. “Neighbors” shift to the side and bend, replacing the defect. If dentures are not put in place within a few months, the dentition will fall into disrepair.

Symptoms

The diagnosis of crooked teeth includes many different defects. It is difficult to call them diseases, rather they are cosmetic problems. Only in rare cases, there is a serious violation of chewing function. Usually, the teeth are “lapped” to each other, and there is enough contact between them to chew confidently.

There can be irregularities:

  • The location of the teeth;
  • The direction of growth;
  • Tooth size;
  • The shape of the crown of the tooth.

Humans are mammals, and teeth are very different. But for each tooth there is a fairly accurate version of the norm, and small deviations make the tooth row unsightly. Large or small teeth, sticking out forward or backward, displaced to the side, not fit for purpose (incisors, canines, molars) – this is the wide range of defects that patients go to the orthodontist with.

Normally, the crowns fit snugly against the adjacent ones, or the gaps are minimal. Those that are enlarged, called “birdhouse”, do not look good, and can cause damage to the gums while chewing.

The symptomatology of bite irregularities is usually obvious, and an experienced orthodontist does not need additional tests to clarify the diagnosis. X-rays are helpful in some cases. Teeth (more often canines) can be displaced by the growth of extra teeth, which normally should not be there. The location and angle of the roots of teeth “number 1” and “number 2” are determined on the X-ray and assessed how healthy they are. Then the decision is made to keep or remove some of them.

Contraindications to treatment
To correct bite anomalies, orthodontists have invented many effective methods. They are based on not too much, but constant pressure on the teeth, so that the crowns eventually take the optimal position. To a certain extent, orthodontic intervention is traumatic, and the presence of foreign objects in the mouth can adversely affect the human body.

  • Therefore, there are contraindications to orthodontics:
  • blood diseases;
  • tuberculosis;
  • HIV;
  • diabetes mellitus;
  • diseases of the immune system;
  • some forms of osteopathies, osteoporosis;
  • most mental illnesses;
  • poorly compensated diseases of internal organs.
  • Oral interventions should not be performed if there is bleeding, poor wound healing. The patient can harm himself with the orthodontic appliance, or he will hinder the actions of resuscitators in case of decompensation of chronic disease.

Important: It is the physician’s duty to focus on the vital organs first and consider the potential risks of orthodontic surgery. Patients should be sensitive to prohibitions and not insist on life- or health-threatening interventions.

Treatment

The most effective and popular method for correcting crooked teeth in adults is braces. But there is an alternative: removable transparent mouth guards or dentures.

Prosthetics show good results when the gaps between all of the front teeth are wide. In this case, no matter how correct the position of the crowns, the smile will not get prettier. Durable, color-matched ceramic fillings (veneers and lumineers) can widen the gap between natural teeth. Crowns are shaved, and dentures must be worn for life. Their average lifespan is several years. The patient should keep this in mind when going to the dentist.

Restorations with specific composite materials also help. It is best used when there are cavities or other defects in the crown. Composites require regular polishing, but in some cases they are the best choice (deep cavities on the incisors).

Transparent mouth guards (eliners) are made of polymers with the optimal combination of stiffness and plasticity for this purpose. They are placed over several neighboring teeth, more often over all of the front teeth at once. The mouth guards are worn most of the time around the clock and are removed for eating and brushing.

Advantages of mouth guards:

  • They are easy to remove;
  • Invisible on the outside;
  • Safe for children;
  • The child gets used to them very quickly;
  • diction is preserved;
  • mucous membranes are not traumatized;
  • the tooth enamel is not damaged.

Disadvantages of eliners:

  • are only suitable for the simplest defects of the dentition;
  • the production of mouth guards is only possible by a dentist with high qualifications.

The mouth guards exert little pressure on the teeth and cannot correct defects such as the rotation of the crown around the axis. But in simple cases, patients may be more comfortable wearing them than braces.

Braces

Braces are graceful dental onlays that connect several adjacent crowns. Unlike the more massive and removable brackets, which only close around the edges, the thin wires of braces connect at each interdental space. It is not the wire that presses on the tooth, but a flat plate made of metal, stone or ceramic, or plastic. Trauma to the enamel is minimized and there is no cavity in the tooth.

According to the type of attachment, the braces can be ligature braces with a latch on the orthodontic arch (elastic ring) or ligature braces with a slot that is closed with a latch.

There are many types of braces. Some play a purely decorative role, not correcting the position of the teeth. Such jewelry can be seen in famous people who like extravagance, they have even become fashionable in recent years. The most expensive are sapphire braces, with artificial semi-precious stones. They are beautiful, but may be too hard for enamel. Ceramic (porcelain) is good because it is easy to match the natural color of the enamel. Plastic ones are the most economical, but they need to be replaced more often; staining of plastic by food and drinks is possible.

Dentists recommend more practical and safer designs made entirely of metal. Making parts from the same alloy eliminates the formation of electrochemical stresses in a liquid environment. Metal does not corrode in saliva, and treatment is optimal. If metal crowns are already on the teeth, it is better to choose a similar alloy for the braces. Expensive decorative items are made of gold. Biologically compatible titanium and “stainless” nickel are used.

More often, braces (pads) are placed on the outer side of the teeth, next to the lips and cheeks. But they also make lingual braces that face the inside of the mouth. Placement near the tongue impairs the pronunciation of sounds and interferes with eating, so this option is rarely used. Indications may be the presence of trauma to the mucous membrane of the cheeks, the occurrence of tumors on them in the past. If there is a tumor in the present, even if benign, this is a definite contraindication to the installation of braces. The main advantage of lingual braces is their inconspicuity. Only a narrow strip of metal is visible on the outside of the teeth.

How long will braces last? Usually from a year and a half to three years. The patient should be prepared for a long period of treatment. It is better to treat the braces as a decoration, and find the aesthetic sense in wearing them. Then there is no psychological discomfort.

It is evident that it is more pleasant to wear attractive-looking braces. If funds allow or the appearance is very important for the patient, it is possible to order braces that are not inferior to jewelry. Sapphires are just one of the possible designs.

The first signs of improvement in the bite appear 3-4 months after the placement of braces. But you cannot take them off, your teeth are still unstable in the new position, and they will easily return to their previous wrong position. The patient sees the dentist regularly, the constant supervision of a specialist is necessary for the condition of the teeth.

Do not worry, the doctor will not “overdo” the braces unnecessarily on the teeth. If the patient wants to wear braces in the future as a decoration, other braces will be made that do not exert too much pressure on the teeth.

It takes about an hour and a half to install the braces. The teeth are professionally cleaned, rinsed, dried, etched with antiseptics, washed and dried again. Then primer and adhesive are applied, which is the glue used to hold the braces in place. The braces are fixed, excess adhesive is removed and polymerized with a powerful light beam.

When wearing braces, special oral care is required. The teeth are cleaned with a special brush. Brush your teeth thoroughly, but gently, after each meal. You have to exclude hard foods from your diet: nuts, tough vegetables and fruits. Carrots or apples can be grated or ground in a blender. It is better to eat less hot and cold foods, as well as sweets, which cause increased bacterial growth in the mouth. Changes in temperature cause the crowns to shrink and expand. Germs can cause tooth decay, and braces will have to be removed prematurely to treat it.

Prevention

Preventive measures are based on the probable causes of crooked teeth. Already from the age of 6 months of a child should be attentive to the erupting teeth. It is no secret that natural feeding is better than artificial feeding. The later the baby is introduced to the rubber pacifier, the better. Special orthodontic bottles are available for feeding babies. But children over a year should be given sufficient chewing. Preferably in the form of solid food, not a pacifier.

The child should be gently, but insistently get rid of bad habits. He should not suck his fingers, chew on his nails, to take in his mouth foreign objects. You need to give your child a spoon, size appropriate to age, with a comfortable handle and cup. If the baby is stubbornly pulling his hands into his mouth, smear something bitter on his fingertips. But perhaps he was hungry or nervous, many “bad” habits indicate a nervous breakdown.

It is helpful to see your child to the dentist more often. If they don’t go to children’s institutions or for check-ups, parents should sometimes take their little ones with them when adults go for treatment. Although it’s rare for a child not to have cavities on their baby teeth.

Adults have to get rid of their own bad habits. Smoking not only affects the bite, but also gives the teeth a nicotine yellow tint. If a tooth is lost, it should be replaced as early as possible with a prosthesis – a metal-ceramic crown on a post, a bridge or an implant.

Besides the correction of the bite itself, sometimes you need a more complex treatment. For example, if the lower jaw is too small from birth, you will need developing exercises, physical therapy, and in severe cases – surgery. Otherwise you will not be able to correct the bite just in the orthodontist’s office, and it will certainly be wrong.

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Dr. R.Mammadli (Dental Expert Team)

Bachelor in biotechnical medicine. Author of several medical blogs, author of articles on dentistry and oral health.