Dr. Greg Jorgensen
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1401 Barbara Loop SE
Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

Could My New Braces Be Making My Teeth Worse?

Posted by Dr. Jorgensen on July 26th, 2011

WorriedI just got my new braces on last week. Funny, but I think they’re making my teeth worse! I have a gap where there wasn’t one before and one of my lower front teeth is now more crooked that when I started. Is this normal?

Straightening the teeth is a dynamic process; your teeth will be changing throughout treatment. During the process of alignment, especially during the first 6 months, you may notice that things look worse before they look better. Here’s why:

Although your teeth are crowded and crooked when you first come in to see Dr. Jorgensen, they have usually drifted into a position where they are stable and functional. Your body is amazing at adapting to problems that exist. If you have a lower jaw that is smaller than the upper for example, the top teeth will be pushed back by your upper lip and your lower teeth will be pushed forward by your tongue. We call these “dental compensations.” If the teeth are crowded, the crowding is usually spread evenly among the teeth.

We approach straightening teeth in stages. The first stage is to unravel any crowding. If you have teeth removed, you may notice improvements in the appearance of your teeth right away. If you do not, you may actually notice changes in the alignment of your teeth that temporary make them look worse. You could get spaces where there were none before. You may notice that teeth that were once straight now overlap. You might even notice that although most teeth look straighter, one or two may actually get more crooked! This is because the braces will take all of the crowding that was spread out over several teeth and consolidate it in one or two areas. This is completely normal and necessary.

In the process of removing dental compensations, you will notice changes in the relationship of the upper and lower teeth. If you have a lower jaw that is smaller than your upper, aligning the teeth may actually create more of an overbite. If your upper jaw is smaller than your lower, aligning the arches may create an underbite where there wasn’t one before. These changes in your bite are normal and should be anticipated.

After the crowding is resolved and the teeth are aligned, the next step is to level the arches. If you start with a deep bite, the goal is to “open the bite” so that your lower teeth are more visible. If you start with an open bite, we’ll want to deepen the bite so the top teeth overlap the bottom ones. About the same time we address the vertical relationship, we also work to make the width of the upper and lower arches match (coordinate the arches).

The final stage of treatment is to optimize the over bite or under bite. This may be done with rubber bands, functional appliances, extractions, or orthognathic surgery. Because the teeth are usually straight by this stage, this is the time that is the most frustrating for patients. This is when we start hearing “When will I be getting my braces off?”

Understanding this sequence will give you an idea of where you are in your treatment. Knowing that there will be transitional changes along the way that may actually make things look worse before they look better will make you more confident that your treatment is going as expected.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

122 comments so far in response to “Could My New Braces Be Making My Teeth Worse?”

  1. A w says:

    I have had smart moves for two months now to correct a cross bite and a rotated bottom canine, but now my two front teeth (which were fine before) are now shifted where one looks longer than the other. Is this shift normal in the process? If not, what should be done?

    • I use clear aligners only for the most simple of tooth movements. They do not give me the control I have with braces (especially for rotating canines) and they do have side effects like the ones you’ve described. If you were my patient, we’d place partial braces and get this corrected quickly.

  2. Anna says:

    I’ve had fastbraces for a little over 3 months and noticed that one of my top front teeth is significantly longer than the other and BOTH of my top front teeth are moving very far to the left! My teeth were straight before. Whats going on?

    • Changes in the length and angle of the teeth after the first wire are placed are directly related to the position of the brackets on the teeth. If the brackets are placed at different heights on adjacent teeth, the one with the bracket placed higher on the tooth will become longer within days of wire placement. If the brackets are placed at an angle on the tooth, placing a wire in the bracket will cause the tooth to tip according to the bracket position and the result may be that the teeth shift to one side or the other. Placing brackets is one of the most crucial steps of orthodontic treatment. Training and experience are needed to do it correctly. Specialists receive 24 to 36 months of supervised university training before they treat patients on their own. Primary care dentists who place orthodontic brackets usually have only a few days or weekends of training before they attempt it.

  3. RC says:

    I have a huge gap between my two front teeth that was never there before I had braces; and the braces come off in two weeks!! Will this be there for the rest of my life?

  4. Ayushi says:

    I got braces for my upper jaw in August 2014 and 4 four months later I got braces for my lower jaw. What concerns me is, the band for my upper jaw hasn’t been changed at all and one of my teeth in the lower jaw is longer than the other. Also one of the wires in my bottom teeth keeps coming out and I have to push is back with my finger. I’m genuinely worried.

  5. Andy says:

    I got mu braces around 3-4 months ago. But I noticed that my mouth and lips are actually not symmetrical and one side of the mouth is slanting downwards. My upper jaw are really crooked to one side and my front teeth are far from being in the middle. Will my braces help make my jaw and teeth completely symmetrical in the middle of my face ? This is quite a big worry for me.

  6. Courtney says:

    Hi! I have had my Damon braces on for seven months and was told it would be a 18 month process. I’m 37 years old and have been excited to see what they have done in the seven months, closing my gap in the front and moving another tooth into position that was far back. I was just in last week to see my orthodontist. I just noticed tonight that I have a gap just two teeth over from my front teeth that wasn’t there before and that same tooth seems thinner. It is freakin me out. I’m not scheduled to go back to see the Orthdonist for another four weeks. Us this something to be concerned about?

    • There are changes that occur in transition during your treatment. You shouldn’t worry about a small space this early. Ask your orthodontist to explain what is going on at your next appointment.

  7. mani says:

    Dear Dr,

    Is the placement of every bracket on a tooth so important? bcos in my upper arch, one side brackets are bonded in the center of each tooth and other side brackets are bonded on top edge of the teeth.
    The teeth which have brackets at the top, seems to be coming down and make my bite worse. I asked my orthodontist. He said it is okay. Pls give me your advice.

    Thanks in advance.

    • Bracket placement is THE MOST IMPORTANT THING about putting the braces on. That determines where the teeth will move as you have seen. If they are not put on the correct location, they can even make your bite worse than before.

  8. Amren says:

    I recently started with six months smiles and I am notices my front teeth are shifting to the left. My dentist is capable of correcting this right? I am starting to worry as it has been less than a month and I see some positives and NEGATIVES. Will my front teeth re-center itself further along in the treatment?

    • When midlines do not match after alignment, it is usually due to a tooth size discrepancy or an asymmetry in one or both arches. These problems are common issues that orthodontists fix all of the time. I don’t know if your dentist will address them in the short time he’ll have your braces on. Six Month Smile dentists have different goals than specialists.

  9. Kita says:

    The orthodontist put one of my brackets off centre on my tooth. Will this matter, or is it a technique to help move the teeth?

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