What options are available for fixing crooked teeth?
Depending on the severity of misalignment and the number of teeth involved, there are several options available for correcting crooked teeth.
If there are only a few teeth involved, sometimes tooth-colored bonding (composite) is a good way to go. Of course, this method does not actually move the teeth; it simply makes them appear straight cosmetically. It involves minimal tooth preparation, which allows your natural tooth structure to be somewhat preserved.
The doctor may need to shave the tooth slightly just to facilitate the adherence of the dental materials. The remainder of the procedure typically involves a 2- or 3-step process. First, an etchant (usually phosphoric acid) is applied to the tooth. This creates microscopic finger-like projections into the tooth structure, giving the adhesive something to grab on to. The second step is to apply the adhesive. This is a crucial step as it allows the composite material to adhere to the tooth. These materials are typically cured with an ultraviolet light, which makes the procedure less time consuming. Usually, the doctor and assistant will wear orange glasses or use an orange shield to protect their eyes from the ultraviolet light. Many times, the doctor will save a step by using more modern products that combine the etching and bonding materials into one product.
Once the tooth has been properly prepared, the composite material is applied to the tooth or teeth. Before being cured, composite material has a consistency similar to that of Play Dough. This allows the dentist to sculpt the material and mold it to suit the needs of the particular situation. In this case, the illusion of alignment is the desired result.
This typically involves several consecutive sessions of applying material, shaping it accordingly, and curing it with the light. With good color matching and artistic shaping of the composite materials, the final result is that you have natural looking teeth that appear to be straight. Only you and your dentist will know otherwise.
Another way to create the illusion of straight teeth is to accomplish the same effect as described above using porcelain laminate veneers. This will require more tooth preparation at least two appointments. More tooth preparation means that more tooth structure needs to be removed in order to make room for the veneers. Most dentists are very concerned about preserving, and will do whatever they can to minimize the removal of healthy tooth structure.
At the first appointment, impression will be taken, the tooth or teeth involved will be prepared, and instructions will be sent to a dental laboratory to prepare the porcelain veneers. Usually, there is a seven-to-fourteen-day waiting period while the lab makes the items ordered. Meanwhile, your dentist may place temporary veneers for you to wear while waiting. Some dentist may omit this step because temporary veneers are very difficult to keep in place. Many times they fall of and the patient is inconvenienced by making several trips to the dentist to have the temporaries re-cemented.
The second appointment usually involves removing the temporary veneers, if any were placed, trying the veneers, and if everything fits well and looks good, they will be permanently cemented in place.
This procedure accomplishes pretty much the same effect as using the composite bonding, i.e. it give the illusion that the teeth have been straightened. The difference is that porcelain veneers are more structurally sound and need less touching up and maintenance. Composite materials can absorb colors and become stained over time while this does not typically occur with porcelain veneers.
In cases where several teeth are severely damaged or decayed, crowns and bridges and be utilized both to repair the teeth and simultaneously create the illusion of straightening. This is done simply by instructing the dental lab to fabricate the crowns and bridges to in such a way as to make the teeth appear straight.
The techniques described so far have not involved actually moving teeth into alignment in order to achieve straight teeth. Doing so involves a dental specialty known as orthodontics. Any dentist can perform orthodontics, but an orthodontist is a dentist who has additional training and specializes in that field.
Traditional orthodontics brings to mind a picture of a young teenager wearing “wires and brackets” on the teeth. In many cases, traditional orthodontics are the best way to go. However, there have been many advances in the field of dentistry where other options are becoming available.
One option to consider is the use of orthodontic appliances to move teeth into place. A relatively new product called Invisalign has become increasing popular among dentists and patients. Invisalign is basically a clear rigid appliance that resembles a type of mouth guard. It’s actually a series of appliances that gradually moves your teeth into position. It involves having impressions taken and possibly having some composite materials temporarily added to some teeth that may need to be moved more distance than others.
Once the appliances are made, the patient is given the first set in the series. This set is worn for a prescribed period of time and then the patient returns to the office to have the next set delivered. This continues for a number of weeks or months until the dentist and patient are satisfied with tooth alignment. When the teeth are aligned satisfactorily, the patient then will wear a retainer (usually the last set of appliances in the series).
Many dentist prescribe a one- or two-year period of retainer wear to stabilize the new positions of the teeth. However, more and more dentists are recommending that patients keep their retainers even after the two years are completed. The reason for this is that the teeth are naturally inclined to drift back into their genetically preprogrammed positions. Keeping the retainer beyond the two-year period, or even for a lifetime, is generally a good recommendation. If the patient keeps the retainer, it can be worn from time to time to prevent drifting and the possible need for future orthodontic procedures.
In some cases, the misalignment of teeth is so severe that traditional orthodontics are the only option. Some cases are so severe that surgical intervention may be required in order to move a particular tooth or teeth into position before traditional orthodontics can be started.
Of course, the best advice anyone can give regarding your dental health is to talk with your dentist. Even better than that; obtain a minimum of three opinions before proceeding with any major dental procedure. At least one of those opinions should come from a specialist in the field.