Whether the jaws are small or the teeth are big or a combination of both, crowding occurs when there is not enough space to accommodate all of the teeth. Without enough space, the teeth will either erupt out of place, erupt rotated or fail to erupt (become impacted).
There are two ways to deal with crowding; either make space with dental extractions or create space with an orthodontic appliance.
Sometimes crowding can wait to be treated in full braces but often crowding is better dealt with at a younger age. Early, interceptive treatment can prevent the teeth from erupting rotated or out of position in the first place.
If the upper jaw and palate are narrow, this can cause crowding. Widening the upper jaw with an orthodontic appliance will improve spacing. Sometimes partial or full braces are used to improve spacing issues. Other orthodontic appliances such as headgear can also be used to create space.
Sometimes, when the crowding is severe, permanent teeth are extracted to create space. Several factors are taken into careful consideration when making the choice to extract permanent teeth; position of the jaw bones, profile and facial balance to name a few. Having permanent teeth extracted to create space may be the perfect option, however, the decision should be made with careful consideration.
The benefits of dealing with crowding early is that you can often prevent teeth from becoming impacted by making room for them to erupt. You can prevent decay since crowded teeth can be hard to clean. You can prevent the teeth from erupting very rotated or outside of the arch. If the teeth are left in a crooked position for long, they will develop some memory in that crooked position and may become more difficult to align and more difficult to keep aligned (harder to hold). You can reduce the risk of recession which sometimes occurs when the teeth are crowded. Also, creating space early can minimize the risk of having to extract permanent teeth in order to make space. The American Association of Orthodontists recommends each child have an orthodontic evaluation by the age of seven. If you are concerned about dental crowding, contact us to schedule a consultation.