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

I 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 me, they have usually drifted into a position where they are relatively 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 treatment in stages. The first stage is to unravel the 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 during treatment 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 improve the “overbite” or underbite. 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 nearly 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 is 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. Please understand that because he has tens of thousands of readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. 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.

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

  1. aayushi says:

    hello sir. there is an important question of mine. i got my braces 6month back and i am on my alignment phase. i m noticing a worst change on my upper front teeths. they are moving in forward direction and i feel like they have become worse with time. is it a part of treatment or should i discuss it with my doctor.

    • This is very common and should be discussed with your doctor. Some patients need teeth removed because when the front teeth are aligned they move so far forward that they are unattractive. This is usually predictable before treatment begins, but not always. Please discuss this with your doctor

  2. Donna Davidson says:

    My 13 year old son had some overcrowding with his upper teeth and a 6mm overbite. He had two upper pre-molars removed. He has been wearing braces for 8 months now and during month 6 he had elastic bands put on his braces to bring his upper teeth backwards. He wore the bands day and night as instructed. The bands worked too well and caused him to have an underbite. His orthodontist then told us to not wear bands in month 7 in the hope that his upper teeth would naturally move forward again. We are due to see the orthodontist again tomorrow and my son now has an edge to edge bite. The orthodontist said he may have to wear elastic bands in the opposite direction to bring the upper teeth forward. I am concerned that wearing bands in the opposite direction will bring the lower teeth backwards instead or bringing the upper teeth forwards, thus causing another problem. How would you correct the problem the bands have created?

    • I would do the same as your orthodontist. It won’t take much to get them to cross back over and you can have your son stop as soon as the correction is complete. This is not a big deal. Good luck!

  3. Donna Davidson says:

    Thank you very much for your reply. My son has now had the bands fitted again (in reverse) and his upper teeth are starting to move forward again to create a natural bite. Phew! I must say, your blog is excellent. I have read many articles, all of which explain so much about orthodontics, the processes used and the reasons behind them. You really put my mind at rest. Thank you, from your biggest fan in the UK!

  4. Erica Rangel says:

    I got my braces on a week ago and I am already noticing a gap between my two front teeth. I also notice tooth #9 is overlapping on tooth #10. I had it overlap but I feel like it’s even more now. I was wondering if that will go away and when or how? And is the gap going to get bigger? Or how big does it usually get? Also, how long do each stage last? I was told i would have my braces for 2 years.
    Thank you!

    • Hopefully your gap will get bigger, meaning that it will continue doing its job. As for the alignment of the teeth, that will only happen after you have braces placed on the teeth.

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