My teeth were perfect until my wisdom teeth came in. Now the lower ones are all messed up. Can’t I just get braces on my lower teeth and put them back where they were?
Single arch treatment is possible… under the right circumstances. The determining factor is the relationship between the lower and the upper front teeth (commonly referred to as “the bite.”) The depth of the bite as well as the amount of “overbite” both figure in to the decision.
When crooked or overlapping teeth are straightened with braces, they move forward. If you have and overbite before treatment, aligning the crooked bottom teeth will improve it. If your front teeth come together in an edge-to-edge or underbite relationship at the start of treatment, treating the lower teeth only may actually make matters worse. As the lower teeth move forward, the front teeth may not come together at all after treatment. Although the teeth may look straighter, the bite may be worse.
One of the most common reasons the teeth get crooked with age is the deepening of the bite. As the backs of the upper teeth “push down” on the lower front teeth, they tend to push them back making them overlap. In these cases there is usually no clearance between the backs of the upper teeth and the fronts of the lowers. Without clearance, it is nearly impossible to realign the lower front teeth without repositioning the uppers too. Space between the upper and lower teeth is necessary because the lower teeth will move forward as they are straightened.
One option that can be considered as an alternative to full upper and lower braces in the case of lower crowding is interproximal reduction (IPR), also known as air-rotor stripping (ARS) or slenderizing. Using thin diamond disks or files, small amounts of enamel are polished away from the sides of the crooked teeth providing the room needed for their alignment. Teeth altered in this way don’t need to move forward as they are aligned.
In more severe cases of lower crowding, the removal of a single front tooth may be considered. This is an attractive option if one of the lower teeth is badly worn or there are problems with the overlying gums or bone. Eliminating a tooth that has lost its support can actually be a blessing if keeping it will require extensive gum grafting and aggressive slenderizing of perfectly normal teeth.
Dr. Greg Jorgensen is a board certified orthodontist providing braces and Invisalign to children, teenagers, and adults in Rio Rancho, New Mexico and Westside Albuquerque. He also lectures nationally on practice management, information technology, and current treatment techniques in orthodontics.