Crooked Lower Front Teeth

By Howard Glassman, D.D.S.

Dr-Howard-Glassman

Howard Glassman, DDS, has been practicing general and cosmetic dentistry in Orange County, California for over 24 years.

Have you ever noticed (if you haven’t, you will now) that a great many adults have crooked lower front teeth? Sometimes, it gets bad to the point where one tooth is almost completely behind the others. This can happen with people who had naturally straight teeth or had them straightened with braces when they were younger.

There is an unexplained natural phenomenon that explains this (?).  For some unknown reason, all teeth, especially lowers and especially back teeth, tend to drift forward with time. This is why it is always important to replace back teeth when lost (or the one behind will tip forward into its place and the whole bite gets thrown off).  This is also why it is important to put space maintainers in when back baby teeth are lost too early (or the teeth behind will drift forward and block out the erupting permanent tooth).  Anyway, this phenomenon extends to areas with missing teeth, or to a full arch of teeth. As these teeth tend to drift forward, they put pressure on the front teeth and tend to make them crowd.  For whatever mysterious and unexplained reason, this happens on lowers much more than uppers.  If you watch closely (I admit it- I do), you’ll see that even movie stars, news people, and other movie and TV types “suffer” from this lower front tooth malady.

How do wisdom teeth enter into this formula?  There is a large controversy here. Some dentists, joined by a general opinion of the public at large, feel that wisdom teeth coming in put extra forward pressure as described above, and are the real culprits in this front crowding.  There have been, however, a number of studies of this, examining thousands of adults over many years and noting this result: Many adults have crowded lower front teeth. The number is approximately equal between those that had wisdom teeth, and those that didn’t have wisdom teeth. Also, of those adults that still had straight lower front teeth, approximately the same number had wisdom teeth as didn’t have wisdom teeth.  In other words, there was no correlation between wisdom teeth and crooked lowers, indicating that wisdom teeth are not the cause.

Well what’s the big deal anyway you say? There are a few actual real problems associated with this, other than simply the less than perfect cosmetic effect.  The main one is periodontal disease.  This has been discussed at length previously and refers to plaque building up around the gumline and causing destruction of the supporting gum and jawbone.  When teeth are crooked, it is much harder to clean them and keep periodontal disease under control than when they are straight.  I see far greater periodontal breakdown with crooked lower teeth than with straight ones.  Also, the more crooked and overlapped teeth are, the faster they tend to crowd even more. When they are perfectly side to side, there is a resistance to sliding past one another to crowd, but once they overlap, away we go!

What to do??!  The best thing of course is to have braces if needed when young, get your teeth straight and wear your retainer consistently the rest of your life to keep them that way. If you’re relatively young and have nice straight teeth, you probably feel this doesn’t have anything to do with you (and you’re probably not reading this anyway!)

An excellent idea: As so many adult’s teeth do get crowded later in life, one actually should make a retainer now, with your perfect straight teeth, as a record of how they are. You can wear this retainer probably just once a month or so, it should last for many many years and hopefully keep your teeth from ever going crooked. The problem is that once they move and you finally get around to seeing a dentist about it, they’ll probably be moderately crooked already. By then- it’s too late! Now you would have to have braces again to straighten them, and then wear your retainer. So, although this may go against logic and normal thinking, younger folks with straight teeth should get lower retainers made to fit their teeth as they are now, and then you can avoid future crowding and/or future braces.

Nowadays, many adults are getting braces so this goes for you older folks too. Often, a small amount of crowding can be fixed with limited ortho of only a few months, BUT the more crooked your lower teeth are, the harder it is to correct, even to the point that what once could have been fixed simply in 6 to 8 months now takes extracting four teeth and two years.

Lesson: the sooner it’s fixed, the better. Interestingly, if your lowers do get extremely crowded to the point that there is almost one full extra tooth (for the space), then it actually becomes easier!  You can pull one lower front tooth, straighten the rest, close any remaining space, and since the lower four front teeth are the same shape, three of them look perfectly fine and no one will ever notice that  there is one missing.

So, if your lowers are crowding up, 1) don’t feel bad, you have a lot of company, 2) know that the sooner you correct it the better, and 3) no matter how bad it is or is getting, help is available! Come see your local tooth fixer ASAP and we’ll fix you right up.

Call us at 909-860-0321 to make an appointment or click here to request an appointment online.



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