Crowding & Spacing of the Teeth

Crowding of the Teeth

Crowding is the opposite of spacing. It happens when there is inadequate space in the jaws to fit all the teeth. The teeth are tightly packed together and may become crooked or misaligned. The tooth/jaw ratio is not proportional, with the teeth bigger than the available jaw space. Crowding of the teeth could be because of late/early loss of primary teeth, or the abnormal eruption of teeth.

Reasons why crowding should be corrected:

• It increases the prevalence of tooth decay
• It encourages gum diseases
• It produces ugly smiles
• It promotes loss of good teeth function
• It makes some teeth inaccessible for good cleaning

Orthodontic correction of crowding of the teeth

Enlargement of the dental arches, reshaping of the teeth, and selective teeth extraction can be used to create more space. After gaining the space, braces are then used to align the teeth properly and hinder further crowding. Correction of tooth crowding helps in promoting good dental health because plaque that usually forms within inaccessible areas can be properly removed. Severe crowding from small dental arches is best performed with early expansion to restore the arch width before the last teeth erupt, usually age 6 to 8.  Early treatment can prevent the removal of permanent teeth later and provide a more esthetic and more stable life-long smile. DO NOT WAIT FOR ALL TEETH TO ERUPT WHEN THERE IS SEVERE CROWDING, doing so will drastically increase the likelihood of requiring removal of permanent teeth to align the dentition.

Spacing of the Teeth

This is a condition where there is excessive space in the dentition, which gives rise to gaps between the teeth. Factors responsible for the spacing can include congenitally small teeth, a large jaw bone relative to tooth size, excessive tongue pressure and adverse swallowing habits, missing teeth, extra teeth or growths hidden under the gumline, excessive contact with the opposing teeth or a combination of any of these. Space that appears in adult dentitions can be from periodontal disease and bone loss around the teeth.

Reasons why spacing should be corrected:

• It may be a sign of other problems
• It can lead to food impaction and gum disease/bone loss
• Generally opposing teeth will not fit well leading to wear and instability in the arch

Orthodontic correction of spacing of the teeth

Correction of spacing is based on the reason for the spacing but it generally requires braces in both arches; closing space in the upper arch alone for instance will bring upper teeth back and usually into heavy contact which in turn leads to relapse as soon as braces are removed. instead, lower teeth are aligned and pulled back to give the orthodontist room to close the space in the upper arch. Closing space is rarely the hard part of treatment; stability (holding the space closed afterward) is the tough part and it requires experience, compliance with retainers as well as an accurate diagnosis and treatment plan. Otherwise you will find that whatever caused the space will lead to it reopening soon after treatment.