Correction of severe tooth crowding via orthodontic treatment.

This smile makeover simulation illustrates the type of results that correcting severe tooth crowding via the use of orthodontic treatment can give.

Case issues and concerns:

The most obvious issue at hand with this case is the irregular alignment of this person's teeth, both top and bottom. It exists because there's a general mismatch between the total cumulative width of the teeth and the amount of jawbone space that's available. The result is the tooth crowding that's seen.

Gum tissue concerns.

Possibly what's not so obvious is the developing gum condition that exists with this case. When looking at the lower teeth, take note of the light tan calculus (dental tartar) that has formed between the center ones.

This debris, which is attached to the teeth, starts off as dental plaque. But during times when it's not brushed off in a timely fashion it calcifies, thus turning into the tartar deposit you see in the picture.

In regard to this buildup, this person has two issues working against them.

One is the crooked alignment of their teeth. It makes it more difficult for them to brush and floss their teeth effectively. And as a result it's commonplace that some dental plaque gets left behind.

The other obstacle is that this location in the mouth (the front side of the front teeth) tends to be drier than other areas. And as a result, the plaque that tends to accumulate here dries out and is therefore harder to brush off.

Potential problems.

The complication associated with tartar build up is that it causes gum tissue inflammation (gingivitis), which may also lead to damage of the bone surrounding the teeth (periodontitis). Both of these conditions can cause gum recession, and especially in the case of periodontitis, lead to tooth loss.

Whether or not this person seeks treatment for their tooth crowding, they should have a dental cleaning and have their dentist evaluate the current status of the area involved.

Severe tooth crowding, upper and lower arches.
After orthodontic treatment.

Photo submitted by website visitor.

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Treatment solutions:

Our "after" picture illustrates how this person might look after having orthodontic treatment.

They and their dentist might have several different types of orthodontic systems to choose from, although with severe cases traditional bracket and wire techniques often makes the most predictable choice.

Notes about our simulation:

We'll admit that there are a number of issues with our "after" image that should be explained. That's because with an extensive case like this, just photoshopping a picture can't really accurately simulate a treatment outcome. Our only goal with this makeover is to help motivate this person to seek treatment by giving them an idea of what type of changes might be accomplished.

  • The upper central incisors (center teeth). - This case's "before" picture shows some minor chips or wear of the biting edges of these teeth. These defects should be easy enough to correct via the placement of dental bonding, or else just trimming and smoothing them using a dental drill.
  • The upper lateral incisors (the teeth on each side of the centrals). - The size and shape of these teeth in our "after" picture is simply made up. We've just imagined teeth for the space that exists in this picture. This person's actual existing teeth probably have a slightly different (and probably better) look.

    Whatever size and shape exists, the orthodontic treatment will be able to accommodate them. The orthodontist may push all of the back teeth back slightly to make room for the full width of the upper laterals, or possibly extract a back tooth on each side so to create the additional space that's needed.

  • The upper lower front teeth. - As with the upper laterals, we've just fabricated and pasted teeth into the picture, which we admit makes this aspect of our simulation look a bit "full." In real life, the treating dentist will be able to reposition all of the teeth on the lower arch so to better accommodate the realignment of the lower front ones.

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