Crowded teeth (dental overcrowding in adults and kids)
Crowded teeth (also called dental crowding or ‘overcrowding’) occur when there’s not enough space for the teeth in the jaw. Crowding means teeth overlap, twist or become pushed forwards or backwards out of the arch. This makes them look uneven, crooked or unaesthetic.
In dentistry, crowding is a type of malocclusion, meaning the teeth and bite are not lined up correctly. Crowding affects children and adults and is a common reason people seek treatment.
The best way to treat crowded teeth is with orthodontic treatment such as braces or clear aligners. These systems gradually move teeth into better positions and give patients perfect smiles every time. At Smileworks Dr Eduardo and Dr Ana have treated many hundreds of crowding cases in children and adults so you’re in safe hands. Read more about the different brace systems we offer on our main braces page.
Is tooth crowding a problem?
From a health perspective, perfectly straight teeth are not essential. Many people with mildly crooked teeth keep their mouths clean and healthy without any problems. Slightly wonky teeth never hurt anyone. But more severe crowding can make teeth difficult to clean so plaque builds up between the overlapping teeth. Over time this may increase the risk of gum disease, tooth decay and uneven tooth wear. Wear is difficult for dentists to fix and can be expensive.
The literature is not entirely clear on whether crooked teeth really are a problem for the health of your smile and if you brush and tepe correctly we’re not going to pretend there’s big problems for you down the road. The aesthetic problems far outweigh the dental problems for most patients. If you need some help getting to sleep tonight, here’s the study (systematic reviews: Bollen et al., 2012; Addy et al., J Clin Periodontol).
The best way to find out whether crowded teeth need treatment is with a proper orthodontic assessment. At Smileworks Liverpool we offer consultations for both children and adults, where we can assess your bite, explain your options and advise whether treatment is necessary. Book an orthodontic assessment here.
What causes crowded teeth?
Crowded teeth develop when there’s a mismatch between the size or number of teeth and the amount of space available in the jaw. Sometimes the jaw doesn’t grow large enough to comfortably fit all the adult teeth. Also the teeth might be larger than average. When this happens the teeth compete for space and are pushed out of line, overlapping or twisting as they erupt.
Teeth can also shift gradually over time. Even in adults who once had straight teeth, slow natural movement of teeth cause crowding later in life, particularly in the lower front teeth. Relapse after orthodontic treatment is another common cause. If you don’t wear your retainers, teeth often drift back towards their original positions and crowding can return.
Wisdom teeth are often blamed for crowding but the evidence is mixed. While erupting wisdom teeth may sometimes contribute to pressure, most research says they’re not the main cause on their own. In many cases, crowding develops from a combination of these factors rather than one single cause.
Measuring crowding
Crowding is measured at the start of any orthodontic treatment and is classed as either mild, moderate or severe. There are different methods of treating crowding, and it’s almost always braces. We use removable or fixed, although in cases with severe crowding they are usually fixed. The ways of relieving crowding is either to increase the size of the bone that the teeth are in (a process called expansion), by extracting some teeth, or by reducing the size of teeth.
How are crowded teeth treated?
The best treatment for crowded teeth depends on how severe the crowding is, how your bite fits together, and what type of result you’re hoping to achieve. Typically treatment involves gently moving the teeth into better positions and also creating a small amount of extra space. This can be done with arch expansion or IPR (see below)
Braces for crowded teeth
Fixed braces are one of the most reliable ways to correct moderate or severe crowding. Invisalign, Spark aligners and fixed braces are very effective at correcting rotations, overlaps and complex bite problems. Braces are suitable for children and adults.
Clear aligners for crowding
Clear aligners (invisalign and spark aligners) are a great option for mild to moderate crowding. These are removable, invisible trays that guide the teeth into alignment and are popular because they are discreet, easy to clean and you can take them out.
Aligners can be very effective for simpler cases of crowding, but more complex problems may still be better treated with fixed braces. Your orthodontist will advise which option is most suitable for your teeth.
Creating space (enamel stripping or IPR)
Sometimes there’s simply not quite enough space in the jaw to straighten the teeth without first creating a small amount of extra space. This can be done using a technique called interproximal reduction (IPR), also known as enamel stripping.
IPR involves carefully removing a very small amount of enamel between certain teeth to make room for them to align properly. The amount removed is tiny, the procedure is painless, and it does not damage the teeth. This technique is often used alongside braces or clear aligners to avoid the need for tooth extractions in suitable cases.
Extractions
In moderate or severe cases, extraction of the teeth may be required in order to align all the teeth in the arch. When teeth are taken out in the right places, the remaining teeth can be redistributed. This makes more use of the available space and line the teeth up. This may make your smile look better, but it does involve removal of sometimes healthy teeth. Many dentists and patients are not fans of taking out healthy teeth. There have been horror stories about extractions affecting the facial profile of patients. However scientific studies over the years have been conclusive. If done correctly, there’s no difference in the outcome of orthodontic treatment where teeth have been extracted or not. In terms of stability and appearance extractions or no extractions doesn’t make a difference. What does make a difference is doing the orthodontics correctly! Take a look at our main page here: Tooth Extraction Liverpool.
In cases of severe crowding stripping is not an option. The choice of whether to extract or not is done on a case by case basis and must be carefully considered. There are dentists who say “I never extract teeth for braces’; I would steer well clear of those – they are generally the dentists who get bad results as they try and make a treatment fit for every patient. In some patients teeth will need to be removed to relieve crowding, and that is just a fact. Trying to treat an extraction case with non-extraction will end up with an unstable, unaesthetic case. This is not in the best interests of the patient.
Expansion (or arch expansion)
The third option to relieve crowding is expansion. Expansion can work well in children, and is of mixed success in adults. Generally speaking the width of the upper arch at the molars can be expanded by 3mm and still remain stable. This means that treatment in adults is of limited success. If adult arches (the bones that hold the teeth) are over-expanded, it will result in relapse. This is where the bone bounces back and bunches all of the teeth up together. It is all to do with the squishiness of the bones of the head. in kids these are squishy and not fused together. This means we can expand these quite readily with a fixed or removable brace in the palate.
This will result in the bone simply getting bigger over time. After this the child may not need further treatment, or they may need to have the teeth aligned. In adults, the bones of the head are more or less fused, so the amount of expansion that can be achieved to relieve crowding is minimal. in certain instances, and with the right case selection however, some results can be achieved and whether this is the right thing to do depends on the case selection.
If you’re unsure which orthodontic approach is right for you or your child, take a look at an overview of the braces systems we offer at Smileworks here: braces Liverpool. Dr Eduardo and Dr Ana treat both adults and kids for braces at Smileworks and are the absolute experts in crowding, arch expansion and IPR.
If you think you have crowding and would like to speak to one of our dentists or orthodontists (who are experts in overcrowding) then call us on 0151 236 5166 and we’ll be able to help.
Crowded teeth FAQ
Does crowding damage your teeth?
Mild crowding on its own does not usually damage teeth. Scientific studies have not consistently shown that crowded teeth directly cause tooth decay or gum disease, and good oral hygiene is far more important than alignment alone. However, more severe crowding can make cleaning more difficult, allowing plaque to build up and increasing the risk of gum inflammation, tooth decay and uneven tooth wear over time.
Can crowded teeth get worse with age?
Yes, crowded teeth often get worse with age. Teeth naturally continue to move slowly throughout life, particularly in the lower front teeth. This gradual movement is one of the most common reasons adults notice new crowding developing over time, even if their teeth were straight when they were younger.
Do wisdom teeth cause crowded teeth?
Wisdom teeth are often blamed for crowding, but they are rarely the main cause. Most scientific studies show that crowding usually develops because of natural tooth movement, jaw size and relapse after previous orthodontic treatment rather than wisdom teeth pushing the front teeth out of line.
Can clear aligners fix crowded teeth?
Yes, clear aligners can fix crowded teeth in many cases. They are very effective for mild to moderate crowding and are a popular option because they are discreet and removable. More severe or complex crowding may still be better treated with fixed braces, which can move teeth more precisely.
Do crowded teeth need to be treated?
Crowded teeth do not always need to be treated. If crowding is mild and you can clean your teeth well, treatment may not be medically necessary. Many people choose treatment mainly for cosmetic reasons or to make cleaning easier rather than because of health problems.
How long does it take to fix crowded teeth?
Treatment time depends on how severe the crowding is and which method is used. Mild crowding can sometimes be corrected in a few months, while more complex cases may take 12 to 24 months or longer. Your orthodontist can give a more accurate estimate after examining your teeth.
Can crowded teeth be fixed without braces?
In some mild cases, crowded teeth can be improved with clear aligners or by creating small amounts of space using enamel stripping (IPR). However, most moderate to severe crowding still requires orthodontic treatment with braces or aligners to achieve a stable and predictable result.
Will crowded teeth move back after treatment?
Yes, crowded teeth can move back after treatment if retainers are not worn as advised. Teeth naturally try to drift back towards their original positions over time. Wearing retainers long-term is the best way to maintain straight teeth after orthodontic treatment.
To find out more from a real professional you can book your orthodontic assessment at Smileworks here.
