Dr. Murali Mohan

We all love a set of perfectly aligned teeth to show off when we smile. Many get braces done to get this straight set of teeth. However, many people find it mysterious that their teeth have suddenly started to crowd. Somebody could even be in their late 20s, well past their growing years, and suddenly realize that there is crowding setting in for the last few months. It poses a big cosmetic problem and also affects the way teeth bite with each other.

Causes: The sudden appearance of crowding seems very mysterious. However, in most people, there is no exact reason to pinpoint and it seems it is hereditary and genetic. Despite having braces done, there is sudden crowding after the growing years are over. Though an exact correlation has not been established, it is believed that strange habits of people not related to their mouth at all causes tooth crowding. Regular pressure on the mouth by either placing the face on the head or sleeping on the belly puts a constant pressure on the mouth and leads to crowding over a prolonged period of time.

The most logical explanation is however, what is termed as ‘physiologic mesial drift’. By nature, the teeth have a constant, very gradual movement towards the incisors which is the midpoint of the jaw. Given this inherent quality, there is mild constant pressure from the molars towards the incisors and this is what leads to crowding. Stronger jaw bones may slow the process, but it is not yet proven. This physiologic mesial drift is the reason why the lower front teeth are the most common area of crowding.

Management: The earlier the dentist intervenes, the shorter the treatment duration and the quicker the correction. Radiographs and models would be required to identify the problem completely. The bite with the upper teeth needs to be assessed though to make sure it is not very deep. The age of the person also determine the results.

Mild to moderate crowding in this area can be managed with just a lower brace for about 5 to 10 months. In some cases, even an upper brace would be required. In cases of severe crowding, some cases even presenting with two rows of teeth, some teeth definitely have to be removed and the remaining teeth need to be aligned and the extra spaces closed. Severe crowding may also require you to wear a retained for a long period. This could be placed on the inner side (tongue or palatal side) to improve cosmetic effect.

There is no need to panic when you realize the teeth are crowding, there is definitely a way to flash that bright smile again!