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Some very common statements I hear as an orthodontist from patients are "my wisdom teeth got removed and cause my teeth to shift" or "When my wisdom teeth came in my teeth started to shift". While it is a commonly held belief that the wisdom teeth are related to crowding, they are not related. The thought that wisdom teeth cause crowding or make your teeth crooked is somewhat of an old wives tale and is not true. So why do teeth because crowded after braces or Invisalign?

Teeth become crooked after orthodontic treatment for a few reasons. The main reason is lack of retainer wear. Research has shown that orthodontic retainers are the only way to keep the teeth in their new position after treatment and keep tooth movement to a minimum. Without retainers, the teeth will begin to shift and become crooked. Just like anything else in the body, teeth change over time, and maintenance is necessary. Keeping the teeth straight after braces requires wearing retainers for as long as you want them to stay straight.

Another factor that over time can lead to shifting of teeth is what is known as late mandibular growth. Put simply, there is a very small amount of lower jaw growth that happens in the late teens and twenties that puts a slight force on the lower teeth pushing them forward and upward very slightly into the back of the top teeth. Over time, this extra force or pressure can cause crowding of previously straight teeth.

Research at the University of Iowa showed that wisdom teeth can not exert pressure on the front teeth to cause them to become crooked. The way this was discovered was by using sensors that compared the pressure with wisdom teeth and without wisdom teeth. What they found was that there was no difference. Research also compared the amounts of crowding in children after braces with and without their wisdom teeth. There was no difference in the amounts of crowding, suggesting that wisdom teeth do not play any factor in crowding, or shifting of the teeth after orthodontics.

While everything in the body changes over the course of time, when it comes to maintaining the position of the teeth, the most important thing is to continue wearing your retainers for as long as you want the teeth to remain straight. The wisdom teeth do not play a role in cause the teeth to shift.

Our office and the American Association of Orthodontists (AAO) recommends children get their first check-up with an orthodontist either at the first recognition of an orthodontic problem or at age 7. It is important not to rely on your general dentist(the dentist that does your checkups and cleanings) to properly evaluate for orthodontic concerns.

Around that age, children have a mix of baby (primary) and permanent teeth. An examination at this age gives the child orthodontist a wealth of information. If a problem exists, or if one is developing, your orthodontist is able to advise you on which treatment is recommended, when it should begin, and estimate its length. "Waiting for the baby teeth to fall out" without being evaluated and monitored by an orthodontist is a mistake that can lead to serious issues down the road.

If your child is younger than 7, and you notice something that appears “off,” it’s not necessary to wait until your child turns 7 or until you get a recommendation from your dentist. You should take your child to an orthodontist the moment you notice an issue, regardless of age. No referral needed to set up an appointment for an orthodontic evaluation. At Strouse Orthodontics, as well as most orthodontic offices, initial consultations are complimentary. Orthodontists care about the well being and orthodontic health of your family and will be able to advise if any treatment is needed.

What Happens at the First Exam? Generally five questions will be answered

1. Is there an orthodontic problem, and if so, what is it?
2. What are the options to correct the problem?
3. Is there a possibility any teeth need to be removed?
4. How long is the recommended treatment expected to take?
5. How much will the recommended treatment cost?

Frequently Asked Questions

Won't my child's teeth become straighter as they grow?

Unfortunately, a common misconception is that a child's teeth will naturally align as they age. However, the reality is quite different. The space available for permanent front teeth does not expand with growth. In fact, after the eruption of the permanent molars around age 12, there's often less room for the front teeth, potentially resulting in orthodontic issues like protrusion or misalignment. Furthermore, untreated orthodontic problems tend to exacerbate over time and can pose greater challenges as a child matures.

Should I wait for our Dentist to refer my child to an orthodontist?

No. Parents are usually the first to realize something is off about their child's teeth or jaws. If you have any concerns please contact our office to schedule an initial consultation.

Where did my child's orthodontic problems come from?

Most orthodontic problems are genetic. Some are “acquired,” developing over time by sucking the thumb or fingers, mouth breathing, dental disease, abnormal swallowing, poor dental hygiene, or early or late loss of baby teeth, accidents and poor nutrition. Regardless of the cause, an orthodontist will likely be able to treat the condition.

Embarking on the journey towards a straighter, more aligned smile through orthodontics with braces or Invisalign is an exciting and transformative experience. As you enter the world of braces or Invisalign, it is crucial to remember that your orthodontist is just one part of your oral health care team. In this post I will explore why regular dental checkups are essential even when you're undergoing orthodontic treatment.

Oral Health Assessment

While the orthodontist is focusing on straightening teeth and correcting bite issues, your dentist plays a crucial role in ensuring your overall oral health. Regular dental checkups provide a comprehensive assessment of your gums, tongue, cheeks, and the overall health of your mouth. This helps in identifying and addressing any potential issues before they escalate.

Monitoring Oral Hygiene

Maintaining good oral hygiene can be challenging with braces or aligners. The presence of orthodontic appliances creates additional nooks and crannies where food particles and plaque can accumulate. Your dentist will monitor your oral hygiene practices and provide guidance on effective cleaning techniques to prevent cavities and gum problems. It is especially crucial to maintain professional cleanings during orthodontic treatment.

Early Detection of Dental Issues

Dental problems don't take a break during orthodontic treatment. In fact, the presence of braces or aligners can sometimes make it more challenging to detect certain issues. Regular dental checkups enable early detection of problems such as cavities, gum disease, or signs of teeth grinding. Timely intervention can prevent these issues from interfering with your orthodontic progress.

Coordination between Orthodontist and Dentist

Collaboration between your orthodontist and dentist is key to achieving optimal oral health. Your dentist and orthodontist work together to address specific issues, such as restorations after orthodontics, tooth extraction, impacted teeth, or any concerns related to your overall oral health. This coordinated effort ensures that your orthodontic treatment aligns seamlessly with your broader dental care plan.

Conclusion: In conclusion, seeing your dentist regularly during orthodontic treatment is not only advisable but crucial for maintaining overall oral health. The collaboration between your orthodontist and dentist ensures that you receive comprehensive care, addressing both the specific goals of your orthodontic treatment and the broader aspects of oral health. Remember, a beautiful smile is not just about straight teeth – it's also about a healthy and well-maintained mouth.

Over the last decade clear aligners such as Invisalign have gained immense popularity as a discreet and effective orthodontic appliances. Many individuals contemplating improving their smile and bite with orthodontics wonder “Can my regular dentist do Invisalign?”(or any Orthodontic treatment for that matter) While it is true that legally dentists can offer clear aligners, the stark reality is that not all providers are created equal when it comes to understanding orthodontics. 

Clear aligners are an appliance that can be used for orthodontic treatment(to straighten teeth and correct a patient's bite). The success of Invisalign treatment hinges on the proficiency and experience of the practitioner. Here is the candid truth: your dentist may legally offer clear aligners, but without extensive expertise, they may be charting uncharted territory. 

Whether braces or clear aligners are used, orthodontic treatment requires a nuanced understanding of tooth movement, biomechanics, occlusion, growth and development, tooth eruption and comprehensive treatment planning. One red flag to here from a provider is that a dentist states they are “certified in Invisalign” or that they now have new technology to do Invisalign. Clear aligners are not new technology, and Invisalign has been available since the late 1990’s. This is a common phrase used by general dentists to lead unknowing patients to believe they are on the leading edge and experts on orthodontics. The truth is dental school has very limited to no orthodontic training with most programs have nothing more than a few lectures on Invisalign and no hands on training, let alone starting and finishing a case or any fundamental knowledge in orthodontics.

Orthodontic specialists go on to a 2-3 year ADA approved residency program. All Orthodontists are dentists first, and out of 100 dental school graduates only 6 go on to become orthodontics because of the competitive nature. In these residency programs, orthodontists become experts on the skills required to manage tooth movement and guide growth and development while treating hundreds of cases. In practice, orthodontists focus on straightening teeth and correcting bite issues all day, every day.

Opting for clear aligners or braces from an under qualified dentist could lead to suboptimal results, prolonged treatment times, and extensive complications down the road. Most times, dentists will focus on straightening the front teeth that a patient sees and will not address and bite issues. They may not tell you, or even be aware of bite or occlusion issues you may have. A bad bite can lead to many dental problems down the road such as tooth wear over the entire life, TMJ discomfort, and a smile that does not last a lifetime. 

Orthodontists are experts at using both clear aligners(Invisalign) as well as braces, expanders, jaw surgery, and various appliances and are specialists in straightening the teeth and correcting bite issues.

So what should you consider when contemplating orthodontics?

1. Inquire on their specific training and experience in orthodontics and if they are actually an orthodontist. Have they gone to an ADA and CODA approved residency program?
2. Ask if they are confident they can provide the same level of orthodontic care of a licensed orthodontist.
3. Ask to see some cases they have treated that are similar to yours to see before and after photos. Make sure that you are shown the issues, if any, with your bite and how they plan to be addressed. An orthodontic specialist will be better equipped to handle the complexities of treatment.

Having a general dentist perform orthodontics is similar to a general physical doing plastic surgery. While maybe it can legally be done, do you want to risk it? If you needed a knee or hip replacement and your general physician told you they recently got certified in the procedure, you would be skeptical and would would to see an orthopedic surgeon with the expertise and experience to complete the procedure. Just as a cardiologist will have a lot more specialization when it comes to heart conditions than a general physician, the same holds true with teeth and orthodontics.

Remember, while your dentist can legally offer and deliver clear aligners, seeing a provider that completed an orthodontic residency and is best way to ensure your orthodontic care is completed by a real orthodontist. Why risk the health and esthetics of your teeth as well as your money by seeking treatment from a provider with less education, knowledge and training?