‘Crooked teeth’ is the commonest complaint of patients seeking treatment at North Sydney Orthodontics. How we treat crooked teeth depends on what the problem is. We always aim to position the teeth to create a functional and aesthetically pleasing smile, and this may include consideration of the jaw shape and potential growth. Orthodontic anomalies can be categorised into variations of alignment, bite problems, dental disease, cosmetics (tooth size and shape) and functional problems of jaw pain. and obstructed breathing
These problems create a local irregularity within one or other jaw, and usually have only a minor effect on the bite of the teeth. Treatment of alignment problems is usually achieved very reliably and efficiently with invisalign or braces.
1 or more congenitally missing teeth occurs in between 2-5% of the population and depending on which tooth is affected may create aesthetic problems of asymmetry and spacing as well as functional problems by disrupting the normal bite relationships. The principles of treatment are either to completely lose the space or localize the space to permit tooth replacement. More..
Extra Teeth (supernumerary teeth)
Extra teeth (supernumerary teeth) some times grow through into the mouth and create a crowding problem or more often become impeded and prevent the normal growth of other teeth. The treatment of extra teeth is to remove the extra teeth and align the remaining teeth. More..
Crowded, spaced and crooked teeth
Crowding and irregularity of the teeth is probably the commonest orthodontic complaint. Treatment involves alignment of the teeth and may also involve dental extractions if the dentition is excessively protrusive. More ..
Transposition – teeth swapped around in the wrong order
Rarely the position of 2 adjacent teeth swaps over either partially or completely. Treatment can involve correcting the teeth back to the normal sequence or aligning the teeth into the best compromise and undertaking cosmetic dental camouflage .More..
Impeded emergence of incisors
Front teeth occasionally don’t grow into the mouth normally and the most common reason is the presence of an obstruction (usually an abnormal extra tooth) or a malformation of the roots. This problem is noticed around the age of 7-8 years and treatment often involves removal of the obstruction and partial braces to deliver the tooth into the mouth. within the course of the treatment it is rarely possible to completely align the teeth as many adult teeth are yet to develop. More..
Impeded emergence of canine teeth
Ectopic canine teeth occur in about 4% of the population, and results in failure of the canine tooth to grow into the mouth. The anomaly is sometimes present in an otherwise perfect alignment and if the primary canine tooth is retained it may go unnoticed for many year. Alignment of ectopic canines is best performed as early as possible With increasing once the patient has attained 30 years of age the prospects for successful alignment fall to 50% and steadily decline thereafter. More..
Impeded emergence of first molars
Impeded 1st molars is a uncommon problem arising around the age 5-6 years of age. It often results in early loss of the primary 2nd molar and development of early dental crowding. Sometimes the problem resolves spontaneously, but often orthodontic treatment is required to regain the arch space and then maintain it. More..
Impeded emergence of second and third molars
Impaction of the wisdom teeth is a common problem and usually these teeth are extracted, but if other teeth are missing or of poor quality it is often possible to align the wisdom teeth to become fully functioning teeth. More..
Problems of the bite
These problems are often quite complex and often have several different options for orthodontic treatment. In growing children growth modification (dento-facial orthopaedic therapy) is often employed to enhance the jaw growth, but once growth has ceased the options include moving the teeth to disguise the underlying jaw position (orthodontic camouflage) or jaw surgery. Sometimes these problems are associated with major growth developmental anomalies such as cleft lip and cleft palate and other syndromes affecting the head and neck region.
Class 2 growth (relative lower jaw deficiency)
Most commonly this condition is caused by deficient growth of the lower jaw though a similar dental discrepancy can arise if the upper jaw is prominent but this is rare. The facial proportions obviously reflect the underlying jaw bone sizes and the lower lips can be characteristically full. The most appropriate treatment will be determined by the severity of the jaw imbalance but in general treatment is often initiated before the peak growth velocity in the 10-12 age group. There are a range if different solutions to this anomaly More..
Class 3 growth (relative lower jaw excess)
This condition can be caused by deficient growth of the upper jaw, excessive growth of the lower jaw or a combination of both. When the lower jaw growth is excessive it is also commonly asymmetric with one side of the lower jaw longer than the other. This will often show up as a facial asymmetry. Class 3 growth pattern can continue to worsen until the early 20s and some caution is advisable before starting treatment before growth has slowed as there is no way to control the growth. Treatment almost always involves fixed appliances and more commonly dental extractions. More..
Crossbite can appear similar to Class 3 jaw growth but it is not due to a mismatch in the size of the jaws but a local displacement of the teeth due to overcrowding or irregularity. Crossbite is simpler to correct as aligning the teeth also corrects the bite reversal.More..
Deep overbite is signficant because the teeth can chew at the gum attachment of the opposing teeth stripping the gums and then damaging the exposed roots. It is a common feature when the lower jaw growth is slightly deficient but especially when the vertical growth of the face is reduced. Deep overbite usually arises with other orthodontic problems and can be treated using a variety of different methods. More..
Open bite is sometimes due to a developmental stage during the transition from the primary to the permanent dentition and may be prolonged if the tongue is postured forward or a thumb sucking habit is present. In teenagers and adults in the absence of tongue/digit habits the commonest cause for openbite is a discrepancy in the the vertical growth of the face. There is a strong association between obstructed nasal breathing and open bite. This condition has always been a challenge to obtain correction though new techniques have been proven to be effective at correcting this problem More..
Dental and Jaw Asymmetry
Asymmetry usually arises together with a jaw size discrepancy or a small difference in the arch width between the upper and lower jaws. Correcting the alignment of the teeth often improves mild asymmetries. Noticable asymmetry may be caused by missing teeth. The severity of the asymmetry will determine the correct treatment.More.
Problems caused by dental disease, dental injury and dental treatment
Even though dental health has improved a great deal over recent decades there are still occasions when teeth deteriorate to the point where extraction is unavoidable. This can have an impact on the position of the teeth and cause other problems later on. In the right situation orthodontic treatment can help to improve the overall result in combination with other forms of dental treatment. Occasionally orthodontic treatment offers an alternative option to more expensive treatment such as tooth replacement.
Tipped teeth following previous extractions
Following the loss of teeth the adjacent teeth can tip into the space and biting forces may then not pass down the long axis of the root of the tooth leading to breakdown of the bone support and gum attachment. The best way to prevent this is prompt tooth replacement, but once this has happened orthodontic uprighting of the tipped teeth is indicated More..
Space closure for teeth of poor prognosis
The loss of poor quality teeth creates a possible instability in the dentition which may lead to tipping or drifting of the teeth. Replacement of the tooth is an obvious solution but orthodontic space closure may also offer the added advantage of improving the alignment of the remaining teeth as well as avoiding the need for expensive tooth replacements – in fact in most circumstances space closure may be the cheapest long term solution. More..
Orthodontic treatment usually noticeably improves the appearance of the dentition, and very often this occurs as an added bonus to the dental health and functional benefits of treatment. Improvement in the aesthetics is the commonest reason for patients to seek orthodontic correction. More..
Jaw pain and nasal obstruction
Occasionally painful jaw joint symptoms are present or are the main reason for seeking orthodontic treatment. This is a complicated problem. Many factors have been proposed to influence jaw pain, however malocclusion has been shown to have an inconsistent relationship and has largely been excused as a primary cause of problems. Stress is a consistent culprit and because pain is a perception in the brain it is not surprising that psychological factors paly a part as well as primary pathology or demage of the joints. More recently difficulty with nasal breathing and obstructive sleep apneoa have been implicated in the many causes of jaw joint pain. Occasionally the problem is due pain originating elsewhere in the head and neck region, and some practitioners believe the problem can relate to body posture. There is no evidence to suggest that carefully planned and executed orthodontic treatment causes jaw joint problems and unfortunately not much evidence to suggest that it will cure the problem either. Patients suffering jaw joint pain may benefit from discussing this problem with a dentist (who may recommend a dental splint to relax the mouth muscles) or a chiropractor / physiotherapist who may undertake physical therapy for symptomatic relief. Sometimes headaches and facial pains are associated with this condition but headaches may also be a sign of other types of disease arising in the head and neck area which may require medical investigation.