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Teeth erupt crookedly for a number of reasons that range from genetics to mouth deformities and serious oral diseases. When extra teeth or abnormally large teeth create a malocclusion (crookedness or misplacement of teeth), the culprit is usually genetic in nature. Other inherited traits involve jaws that are too small to accommodate a full set of teeth and misaligned jaws that did not form properly in the womb.

Can crooked teeth be prevented?

In most cases, underbites, overbites, and crooked teeth are genetically derived and can’t be avoided. Orthodontic treatment with braces will be necessary to correct the condition once the child is old enough to wear them. However, certain early childhood behaviors may also contribute to the development of crooked teeth that can be avoided. These include:

• Thumb sucking and tongue thrusting
• Losing baby teeth to decay before permanent teeth have naturally pushed them out of their sockets
• Allowing pacifier use to continue after front teeth have erupted

Permanent teeth underneath baby teeth are directly affected by the health of baby teeth. If baby teeth are prematurely lost due to decay or trauma, permanent teeth will shift when they start moving upward. Baby teeth are like anchors for permanent teeth that help guide them as they erupt through the gums.

In addition, excellent care of baby teeth is vital to having healthy permanent teeth free of discoloration or decay. Harmful oral bacteria can spread into the gums and reach permanent teeth still buried in the gums. Once attached to a tooth’s enamel, bacteria will begin eroding the tooth even before it has a chance to take its first bite!

When to Start Orthodontic Treatment for Crooked Teeth

Dr. Kathleen Chan and Dr. Ivy Chen and our staff suggest that parents bring your child to Chan & Chen Orthodontics around age seven to rule out potential issues with permanent teeth eruption. If problems are discovered, it is not unusual to begin orthodontic treatment at that age. In fact, specific conditions such as crowding and gaps between teeth are easier to correct at an early age.

Early treatment also benefits from the growth process of the jaw, which helps move teeth to normal positions.

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

• Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

• Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

• Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

• Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

• Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Andover orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Kathleen Chan and Dr. Ivy Chen will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Kathleen Chan and Dr. Ivy Chen will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Chan & Chen Orthodontics because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

It’s true that orthodontic braces can give you a beautiful smile. But did you know there are other benefits of having braces than just getting perfectly straight teeth? Dr. Kathleen Chan and Dr. Ivy Chen and our team want you to understand the other positives that can come out of having braces and relate to your oral health.

When teeth are crooked or crowded, it’s hard to brush and floss effectively. When there isn’t enough space in your mouth, bacteria and plaque can build up between these teeth. This can lead to serious issues like tooth decay and gum disease. When braces correct the spacing between teeth, and get rid of the tight spaces, patients are able to brush and floss more effectively and not miss essential areas of the mouth.

Surprisingly, braces can also address speech problems. They can shift problem teeth that may be causing embarrassing speech impediments. When an overbite or underbite gets adjusted, patients can pronounce certain words more clearly.

Spaces between teeth may also cause whistling, which braces can fix by closing off the gaps. Word slurring can also be improved with the help of braces by realignment of the jaw or teeth, which opens room for your tongue to move with greater ease.

Braces can also be helpful in supporting the bones and tissues in your mouth. Braces move periodontal ligaments by stretching the connective tissues and nerves. The bones naturally rebuild once they’re settled in their new spot.

Without support from poorly aligned teeth, gum tissue can erode. Braces help prevent erosion of the gums, and will alleviate pressure from the jawbone by fixing a bad bite over time.

If teeth are misplaced, they may not break down food effectively before it enters your stomach. Teeth aid with digestion when you can thoroughly chew your food. If your teeth are badly placed, braces can straighten them for optimal alignment. Once you can chew properly with the help of braces, your food will be more easily and fully digested.

If you have questions regarding braces and how they can help you, contact our Andover office and set up a consultation appointment. Braces can help with many oral health problems, and may save you a lot of money and time in the future.

If you’re not sure whether braces would be worth your time or money, consider the benefits above, and how they add to the value of this treatment. You’ll be getting more than just a beautiful smile!

If Dr. Kathleen Chan and Dr. Ivy Chen and our team at Chan & Chen Orthodontics have recommended a palatal expander, you might be wondering what it is and how it will help you. A palatal expander is a small appliance fitted in your mouth to create a wider space in the upper jaw. It is often used when there is a problem with overcrowding of the teeth or when the upper and lower molars don’t fit together correctly. While it is most commonly used in children, some teens and adults may also need a palatal expander.

Reasons to get a palatal expander

There are several reasons you might need to get a palatal expander:

• Insufficient room for permanent teeth currently erupting
• Insufficient space for permanent teeth still developing which might need extraction in the future
• A back crossbite with a narrow upper arch
• A front crossbite with a narrow upper arch

How long will you need the palatal expander?

On average, patients have the palatal expander for four to seven months, although this is based on the individual and the amount of correction needed. Several months are needed to allow the bone to form and move to the desired width. It is not removable and must remain in the mouth for the entire time.

Does it prevent the necessity for braces?

The palatal expander doesn’t necessarily remove the need for braces in the future, but it can in some cases. Some people only need braces because of a crossbite or overcrowding of the teeth, which a palatal expander can help correct during childhood, when teeth are just beginning to erupt. However, others may eventually need braces if, once all their permanent teeth come in, they have grown in crookedly or with additional spaces between.

If you think your child could benefit from a palatal expander, or want to learn about your own orthodontic treatment options, please feel free to contact our Andover office!