Dental crowding is the teeth overlapping due to a lack of space in the dental arch. This negatively impacts the bite, disturbing not only aesthetics but also the functionality of various maxillofacial structures, such as the mandibular joint and the chewing muscles.
Prevention and early treatment for dental crowding will provide a healthier environment for dental and maxillofacial structures to develop correctly, contributing to harmonized facial aesthetics and significantly reducing the risk of developing other conditions later in life.
What causes teeth crowding?
There are two main causes of dental crowding, the genetic ones, and the environmental ones caused by certain habits.
The genetic ones are:
- Small jaws where the teeth have no space to erupt properly causing an overlapping.
- Cleft lip or palate since these malformations can disrupt the shape of the dental arch.
- Tooth agenesis or congenital absence of one or various teeth.
- The formation of additional permanent teeth (supernumerary teeth).
- Dental maloclussions.
- Teeth with irregular shapes and sizes are common in people with some genetic syndromes.
The ones caused by habits and environment:
- Premature loss of a tooth, whether it’s a baby tooth or a permanent tooth, can cause a displacement in the neighboring teeth.
- Accidents or physical traumas that disturb the dental arch shape.
- Mouth breathing.
- Thumb sucking.
- Use of pacifiers after 3 years of age.
- The habit of pressing the tongue against the teeth.
- Improper oral health habits.
Types of Dental Crowding
Dental crowding is classified according to the number of overlapped teeth or the space (in mm) that the dental arch needs to fit all the teeth properly:
- Mild teeth crowding: It’s when one tooth of the upper or/and the lower arch is overlapped, or the dental arch is missing 3 mm to fit all the teeth properly.
- Moderate teeth crowding: It’s when two or three teeth of the upper or/and the lower arch are overlapped, or the dental arch is missing 4 to 8 mm to fit all the teeth properly.
- Severe teeth crowding: It’s when more than four teeth of the upper or/and the lower arch are overlapped, or the dental arch is missing more than 8 mm to fit all the teeth properly.
Consequences of Dental Crowding
Crowded teeth cause a lot of inconveniences further more than the smile’s aesthetics, in fact, the main issues caused by teeth crowding are functional, since the overlapping, rotation, and malposition of the teeth prevent the upper and lower dental arches from fitting properly into one another, causing a dental malocclusion that will worsen over the time.
Here is a list of the most common problems caused by the overcrowding of teeth:
- Difficulties when chewing or biting.
- Higher risk of developing gum disease and periodontal disease.
- Higher risk of getting tooth decay.
- The oral hygiene routine becomes more complicated to carry out properly.
- Bad breath or halitosis.
- Disfunctions of the temporomandibular joint.
- Pain in the jaw and cracking sounds when chewing.
- Psychological discomfort/insecurities about one’s smile.
What is the best treatment for dental crowding in orthodontics?
Orthodontics offers the most effective solutions for overcrowded teeth, from traditional treatments like braces to most modern alternatives like clear aligners.
The orthodontic treatments for teeth crowding are:
- Braces: Braces are the most effective way to correct the bite and fit all the teeth in place, you can choose metal braces, sapphire braces, lingual braces, or self-ligating braces, they all are suitable for treating crowded teeth.
- Retainers: Retainers are removable appliances that fit over your teeth and exert light pressure over them to correct their position, there are also fixed retained which are small metal bars attached to the inner face of your teeth; both removable and fixed retainers can correct mild cases of overcrowding.
- Palatal expanders: Expanders are appliances that fit over your dental arch and exert pressure from the inside out to slowly expand the maxillary bone gaining extra space so the teeth have enough room to fit properly. This is more suitable for kids and teens since their facial bones are still growing.
- Clear aligners: These are transparent trays that fit over the teeth and exert pressure to guide them into the right position, the aligner’s capacity varies according to the brand you choose, but in general lines, Invisalign provides the highest quality of clear aligners, being capable of even treating severe crowding.
- Tooth extractions: In some cases, it will be necessary to extract one or more teeth in order to create enough space for the remaining teeth to fix properly, but that’s a minority of cases since most of the time dental extractions are not required, braces are enough.
- Dental stripping: This procedure consists of reducing the width of some teeth by filing the sides of the tooth, this creates space between the teeth and allows them to fit properly, it’s a fairly simple procedure, and it’s common in orthodontics.
In some very mild cases, it is possible to use dental veneers to correct the appearance of the teeth, nevertheless, we must make it clear that dental veneers are a cosmetic procedure and even if it improves the smile’s aesthetics, the bite will still have an incorrect shape.
Frequent Q&A
Why are my teeth crowding with age?
It is possible to experience teeth crowding as an adult, teeth crowding with age is usually caused by the late eruption of wisdom teeth, trauma or blows to the jaw, the loss of some teeth, or dental appliances that don’t fit properly.
Fortunately, fixing overcrowded teeth in adults is possible with orthodontics, even if it takes a little longer than it takes in kids and teens.
Teeth crowding after wisdom teeth removal
Teeth don’t crowd after removing wisdom teeth, in fact, the extraction of these teeth can prevent and even reverse crowding by emptying space in the dental arch where the other teeth can fit more comfortably.
However, it is possible that after the extraction you start experiencing unusual sensations in the front teeth, since they might be shifting positions in order to better accommodate in the dental arch.
This position shifting is positive for you since mild overlapping of the teeth might reverse by itself and you’ll also stop feeling pressure from the teeth piling up tightly in your mouth.
Why are my teeth suddenly crowding?
Teeth are in constant movement throughout our lives, even in adult people, so it is possible to experience some teeth crowding as we age, but it’s usually a minor shift.
However, there might be a big and noticeable change in our teeth’ position when we experience periodontitis, tooth decay, bruxism, jaw injuries, tooth extractions, changes in bone structures, etc. Fortunately, these situations are preventable and reversible if you already experienced one.
Are my teeth crowding because of wisdom teeth?
Yes, your teeth may be suddenly crowding because of wisdom teeth eruption, especially if you have a small jaw that lacks the necessary space for the extra teeth to erupt properly or if the wisdom teeth are in the wrong position and are pushing the neighboring teeth.
The inconvenience is usually fixed by extracting the wisdom teeth, then, the remaining teeth will shift back into their original position and you will also stop feeling pressure or even pain over your front teeth.
Is it possible to treat crowded teeth with braces without dental extractions?
Yes, most overcrowded teeth cases don’t require a tooth extraction, most of the time patients only need the correct treatment plan with braces. Only 20% of patients will require a tooth extraction, but it can be avoided using techniques like dental stripping or palatal expanders.
Is it possible to fix crowding teeth without braces?
Yes, there are many other alternatives to fix dental crowding, like palatal expanders, dental stripping, retainers, and clear aligners, which nowadays are as effective as a treatment with traditional braces.
Can Invisalign fix overcrowding teeth?
Yes, Invisalign has many treatment options to treat mild, moderate, and severe crowding cases, it can treat from simple overlapping front teeth to even the most complex malocclusion problems.
You can read all the information about Invisalign treatments here, you can also check the approximate cost of Invisalign for mild, moderate, and severe crowding.
Why are my bottom teeth crowding after braces?
After the orthodontic treatment is over, you must go through a stabilization phase with dental retainers where the final results of the orthodontic treatment get “fixated”. If you skip this part of the treatment there is a high probability that your teeth will start to move back into their original position.
Getting a fixed retainer could be the best and most comfortable option after wearing braces since it consists only of a small metal bar permanently attached to the inner face of your teeth, it is not visible and chances are, you will forget it’s there.
Can bottom front teeth crowding cause pain?
Yes, although it’s a mild pain, it can be very annoying since it will be constant, even if you don’t feel pain, chances are that you will feel constant pressure on your front teeth, which might cause other inconveniences such as headaches.
References
- Patano A, Malcangi G, Inchingolo AD, Garofoli G, De Leonardis N, Azzollini D, Latini G, Mancini A, Carpentiere V, Laudadio C, Inchingolo F, D’Agostino S, Di Venere D, Tartaglia GM, Dolci M, Dipalma G, Inchingolo AM. Mandibular Crowding: Diagnosis and Management-A Scoping Review. J Pers Med. 2023 Apr 29;13(5):774. doi: 10.3390/jpm13050774. PMID: 37240944; PMCID: PMC10222176.
- Turner, S., Harrison, J. E., Sharif, F. N., Owens, D., & Millett, D. T. (2021). Orthodontic treatment for crowded teeth in children. The Cochrane Database of Systematic Reviews, 2021(12). https://doi.org/10.1002/14651858.CD003453.pub2
- Crossley AM, Campbell PM, Tadlock LP, Schneiderman E, Buschang PH. Is there a relationship between dental crowding and the size of the maxillary or mandibular apical base? Angle Orthod. 2020 Mar;90(2):216-223. doi: 10.2319/051019-324.1 Epub 2019 Sep 24. PMID: 31549856; PMCID: PMC8051237.