Dr. Greg Jorgensen
(505) 891-9440
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.

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

  1. Melissa Nia says:

    Your blog site & responses have been a relief to read. Thank you for this info. I have had my traditional fixed upper brace on for 3 months & got the lower brace on last week. It looks clear to me that the orthodontist is jetting my lower teeth (tilting them) forward to bring the lower front teeth closer to meeting the upper front teeth which now also protrudes / fans out forwards, unlike before.

    I think he has done this to relieve the crowding and undo rotating of the canines, but the overjet and teeth fanning forwards do not feel right at all and my overbite has not improved.

    I went to see him today and he said the lower teeth are not tilting / ‘tipping’ forwards and that he is doing ‘BODILY’ tooth movement, which he says will not affect the Lower jaw or bite. I feel like the lowers will move and protrude like horse teeth.

    Is this a normal part of tooth positioning or should I change orthodontists?

    He is fanning the teeth out forwards to create space for the crowding and it doesn’t look to great…he said that with elastics later on, the bite will correct..so my second question is.. will the elastics stop the front teeth protruding too?

    Or should I find a more experiencened ortho to correct my teeth?

    • I cannot evaluate your orthodontist or the position of lower front teeth over the Internet. I will say this however. You cannot move the roots of the lower anteriors bodily if there is insufficient bone. If there was sufficient bone why would you have so much crowding. Flaring or tipping of the lower teeth forward is not always bad, if there is sufficient bone. It is a problem if the teeth are already flared. If you are concerned that the flaring is excessive and his explanations are inadequate, I would seek a second opinion.

  2. ian says:

    Hello Dr.Jorgensen I have my braces 3 weeks ago and notice that there is new teeth coming out at back of my front upper teeth, im 33 yrs of age, is this normal?

    • This is not normal at all. I doubt there is a new tooth coming in at your age. I’d return to your orthodontist and show him what is happening for the most accurate explanation.

  3. Jordan says:

    I started invisalign about 4 and a half months ago and recently have started to notice some weird things happening to my neck and jaw. Im using invisalign because I’m under the impression that it will correct my edge to edge bite. I’ve been biting down on my front teeth for a while now, but its never been an issue until I started invisalign. Recently when I move my neck or swallow I feel a tiny crackling sound around where my Adams apple is. The cracking also moves down to my chest sometimes. Its unusual because its only on the right side of my body. Its kind of hard to exactly explain what’s going on but I feel like the bones from my jaw to my chest are being pulled around. I haven’t really experienced any pain from this yet, but I’m don’t know if this is something I should be concerned about or not. I’ve considered going in to get an x-ray or something but I feel like no one would know what I’m talking about. I’m just throwing this out there to see if this is something you have heard of before. Thanks.

    • I’ve been using Invisalign for 15 years now and I’ve never had a patient report the symptoms you’ve listed here. I would discuss them with your orthodontist but I would also see and ENT to make sure that it is not a coincidental set of symptoms that might be attributable to something else going on. About the only guess I could make is that having the plastic aligners between your teeth all day may be making you clench and/or grind your teeth. This extra stress and tension in the muscles of the head and neck could possibly cause some of the symptoms you’re describing.

  4. Mady says:

    Hello, I’ve had my braces for a year and I think a half. Before I got them tightened my upper teeth were straight (and i don’t think it’s crowded). I got my braces tightened about two days ago and I noticed that my upper front (there a little “buck tooth”) tooth(the one on the right) and the tooth next to it is going outwards and my overbite is getting worse than when it started all in the span of two days! Is this normal? I’m 13 years of age.

    • It is common for front teeth to move forward after the first orthodontic wire is placed. The key is knowing if this is acceptable and what to do if it is not. This is a job for an orthodontic specialist.

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