Most people will face at least one orthodontic problem during their lifetime. Orthodontists estimate that 45 percent of children will need orthodontics to fix problems such as a misaligned bite. Though, 75 percent of children would see the benefits of braces to straighten teeth. The good news is that today’s treatment options are more comfortable and less noticeable than ever before.
In this guide, we’ll explore the most common orthodontic issues, their causes, and the best treatment solutions available. Whether you’re a parent watching for early warning signs or an adult considering treatment, understanding these problems can help you make informed decisions about your oral health.
The Most Common Orthodontic Problems
Understanding common orthodontic issues helps you know when to seek professional care. Let’s explore the main problems orthodontists see in their practices.
Crowded Teeth
Crowding of the teeth is the most common problem associated with the need for orthodontic treatment. This happens when your mouth doesn’t have enough space for all your teeth to fit properly.
What Causes Crowded Teeth?
Several factors can lead to crowding:
- Genetics: Inherited jaw size and tooth size from parents
- Early loss of baby teeth: Can cause permanent teeth to drift into wrong positions
- Extra teeth: Sometimes people develop more teeth than normal
- Jaw size problems: When jaws are too small for the teeth
Problems Crowded Teeth Can Cause
Crowded teeth create more than just appearance issues:
- Hard to clean between teeth properly
- Higher risk of tooth decay and gum disease
- Uneven wear on tooth surfaces
- Bad breath from trapped food and bacteria
- Lower self-confidence when smiling
Spacing Problems (Gaps Between Teeth)
The opposite of crowding is spacing, where there are gaps between teeth. Spaces between teeth are another common problem associated with the need for orthodontic treatment. Like crowding, spacing is also often caused by a discrepancy between the space available in each jaw and the size of the teeth.
Types of Spacing Issues
Diastema: The most common type is a gap between the two front upper teeth. This can be caused by:
- Gum tissue that extends too far down between teeth
- Habits like thumb sucking
- Missing or undersized teeth
- Large frenum (tissue connecting lip to gums)
General Spacing: Gaps throughout the mouth can happen when:
- Teeth are smaller than normal
- Teeth are missing
- The jaw is larger than needed for the teeth
Overbite Problems
An overbite occurs when the upper front teeth overlap the lower front teeth too much. A deep overbite (or deep bite) occurs when the upper front teeth completely (or mostly) cover the lower front teeth. Often, this causes the lower front teeth to bite on the gums behind the upper front teeth, causing damage to the gum tissue and underlying bone.
Signs You Have an Overbite
- Top teeth cover more than one-third of bottom teeth
- Bottom teeth bite into the roof of your mouth
- Wear marks on the roof of your mouth
- Jaw pain or clicking sounds
- Difficulty biting certain foods
Underbite Issues
An underbite occurs when the lower front teeth protrude in front of the upper front teeth. It is often seen with a Class III malocclusion, where there is a large lower jaw, a small upper jaw, or a combination of the two.
What Causes Underbites?
- Genetics: Family history of underbites
- Childhood habits: Thumb sucking, prolonged bottle feeding
- Injury: Trauma to the jaw area
- Jaw growth problems: Lower jaw growing more than upper jaw
Crossbite Concerns
In a normal jaw relationship, the top teeth should be located outside of the bottom teeth. A crossbite can occur with the front teeth (anterior crossbite) or with the back teeth (posterior crossbite). Posterior crossbites usually result from a narrow or constricted upper jaw.
Types of Crossbites
Anterior Crossbite: When upper front teeth sit behind lower front teeth Posterior Crossbite: When upper back teeth sit inside lower back teeth
Both types can cause problems with:
- Chewing food properly
- Speaking clearly
- Jaw growth and development
- Tooth wear patterns
Open Bite Problems
An openbite is defined as a lack of vertical overlap of the incisor (front) teeth. It results when the upper and lower front teeth do not touch when biting down.
Common Causes of Open Bites
- Thumb sucking: Especially if it continues past age 4-5
- Tongue thrusting: Pushing tongue against teeth when swallowing
- Pacifier use: Extended use beyond toddler years
- Genetics: Inherited jaw growth patterns
- Breathing problems: Mouth breathing due to enlarged tonsils or allergies
Problems Open Bites Create
- Difficulty biting into foods like sandwiches or pizza
- Speech problems, especially with “s” and “t” sounds
- Excessive pressure on back teeth
- Jaw muscle strain and pain
Early Warning Signs to Watch For
The American Association of Orthodontists (AAO) recommends that all children be screened by an orthodontist at the age of 7. By 7 years old, your child has enough permanent teeth for the orthodontist to detect and potentially treat jaw or teeth alignment issues.
Signs in Young Children
Look for these early warning signs in children:
- Early or late loss of baby teeth: Children typically start losing teeth around age 5-6
- Difficulty chewing or biting: Trouble eating certain foods
- Mouth breathing: Breathing through mouth instead of nose
- Thumb or finger sucking past age 4-5
- Speech problems: Difficulty with certain sounds
- Teeth that don’t meet properly when biting down
- Jaws that pop or click when opening or closing
- Facial asymmetry: One side of face looks different from the other
Signs in Teens and Adults
Orthodontic problems don’t just affect children. With one-in-three orthodontic patients over the age of 18, the number of adults seeing an orthodontist is at an all-time high.
Adult warning signs include:
- Teeth that are crowded, crooked, or have gaps
- Frequent biting of cheek or tongue
- Jaw pain or headaches
- Teeth that show excessive wear
- Difficulty cleaning teeth properly
- Self-consciousness about smiling
- Changes in bite over time
The Importance of Early Treatment
Early intervention can prevent more serious problems later. The results of this study indicate significant improvements in dental alignment and occlusion in the group of children who received interceptive orthodontic treatment. The average reduction in overjet was 3.5 mm, and the overbite correction averaged 2.1 mm.
Benefits of Early Orthodontic Care
Prevents More Complex Treatment Later: Simple problems caught early often need less extensive treatment than the same problems treated later.
Takes Advantage of Growth: Palatal expander: Your child may be a good candidate for palatal expansion, which can widen the upper jaw and help reduce crowding in abnormally narrow arches. Ideally, a palatal expander is used when a patient is still growing.
Builds Confidence: Children with straighter teeth often feel more confident in school and social situations.
Improves Oral Health: Properly aligned teeth are easier to clean, reducing risk of decay and gum disease.
Phase One vs. Phase Two Treatment
Phase One Treatment (Ages 7-10):
- Focuses on jaw growth and making space for permanent teeth
- Uses appliances like expanders or limited braces
- Typically lasts 12-18 months
- Creates foundation for Phase Two
Phase Two Treatment (Ages 11-13+):
- Occurs after most permanent teeth have erupted
- Uses full braces or clear aligners
- Focuses on final tooth positioning
- Typically lasts 18-24 months
Modern Treatment Solutions
Today’s orthodontic treatments are more comfortable and less visible than ever before. Let’s explore your options.
Traditional Metal Braces
Metal braces remain the most effective treatment for complex orthodontic problems.
How Metal Braces Work
- Metal brackets bonded to each tooth
- Wire threaded through brackets applies gentle pressure
- Regular adjustments move teeth gradually into position
- Most reliable for severe crowding, bite problems, and rotated teeth
Advantages of Metal Braces
- Most effective for all types of orthodontic problems
- No patient compliance needed – they work 24/7
- Fastest treatment for complex cases
- Most affordable orthodontic option
- Durable and reliable treatment method
Clear Aligners (Like Invisalign)
Clear aligners have revolutionized orthodontic treatment for many patients.
How Clear Aligners Work
Clear aligners use a series of custom-made, transparent trays that gradually move teeth. Each tray is worn for about 1-2 weeks before moving to the next one in the series.
Benefits of Clear Aligners
- Nearly invisible when worn
- Removable for eating, brushing, and flossing
- No food restrictions since you remove them to eat
- Comfortable with no wires or brackets
- Fewer emergency visits for broken parts
Who Are Clear Aligners Right For?
Clear aligners work best for:
- Mild to moderate crowding or spacing
- Adults and responsible teens
- People with good oral hygiene habits
- Patients who can commit to wearing aligners 22 hours per day
Lingual Braces (Behind the Teeth)
Lingual braces are attached to the back of the teeth, making them virtually invisible while delivering the same reliable results as traditional braces.
Advantages of Lingual Braces
- Completely invisible from the front
- No patient compliance needed – fixed in place
- Effective for complex cases that can’t be treated with clear aligners
- No risk of losing or forgetting to wear them
Considerations for Lingual Braces
- More expensive than other options
- Initial adjustment period for tongue and speech
- Slightly longer appointment times
- Not all orthodontists offer this treatment
Clear (Ceramic) Braces
Ceramic braces offer a middle ground between metal braces and clear aligners.
How Ceramic Braces Work
- Tooth-colored or clear brackets blend with natural teeth
- Work the same way as metal braces
- Less noticeable than traditional metal braces
- Effective for most orthodontic problems
Benefits of Ceramic Braces
- More attractive than metal braces
- Effective for complex cases
- No compliance issues
- Similar treatment time to metal braces
Choosing the Right Treatment for You
The best treatment depends on several factors:
Your Specific Orthodontic Problem
- Simple cases: Clear aligners may be sufficient
- Complex cases: Traditional braces or lingual braces often needed
- Growing children: May benefit from two-phase treatment
- Adult patients: All options typically available
Your Lifestyle Considerations
Active Lifestyle:
- Clear aligners can be removed for sports
- Traditional braces need special mouthguards
Professional Requirements:
- Clear aligners or lingual braces for complete discretion
- Ceramic braces for subtle improvement over metal
Age and Responsibility Level:
- Clear aligners require discipline and responsibility
- Fixed braces work without patient compliance
Your Budget
Treatment costs vary by complexity and type:
- Traditional metal braces: Generally most affordable
- Clear aligners: Similar cost to metal braces
- Ceramic braces: Slightly more expensive than metal
- Lingual braces: Most expensive option
Most orthodontic offices offer flexible payment plans, and many dental insurance plans provide coverage for orthodontic treatment.
Taking Care of Your Teeth During Treatment
Proper care during orthodontic treatment ensures the best results and maintains oral health.
Daily Care for Braces
Brushing:
- Brush after every meal and snack
- Use a soft-bristled toothbrush
- Brush for at least 2 minutes
- Pay special attention to areas around brackets and wires
Flossing:
- Use special floss threaders or water flossers
- Clean between every tooth daily
- Be gentle around wires and brackets
Foods to Avoid:
- Hard foods: nuts, hard candy, ice
- Sticky foods: caramel, gum, taffy
- Crunchy foods: popcorn, chips
Care for Clear Aligners
Daily Cleaning:
- Rinse aligners when removing them
- Brush aligners gently with toothbrush
- Use special aligner cleaning tablets weekly
Proper Wear:
- Wear 22 hours per day minimum
- Remove only for eating, drinking (except water), and brushing
- Store in provided case when not wearing
Eating and Drinking:
- Remove aligners before eating anything
- Only drink water while wearing aligners
- Brush teeth before putting aligners back in
The Role of Technology in Modern Orthodontics
Today’s orthodontic treatment benefits from advanced technology that makes treatment more precise and comfortable.
Digital Scanning and Imaging
Modern orthodontic offices use:
- 3D digital scans instead of messy impressions
- Panoramic X-rays to see all teeth and jaw structures
- Cephalometric X-rays to analyze facial growth patterns
- Digital photography to document treatment progress
Treatment Planning Software
Advanced software allows orthodontists to:
- Create precise treatment plans
- Show patients what their smile will look like after treatment
- Plan each tooth movement in detail
- Coordinate with other dental specialists when needed
Custom-Made Appliances
Technology enables:
- Custom brackets designed for each tooth
- Personalized archwires for efficient movement
- 3D-printed models for appliance fabrication
- Computer-designed clear aligners
When to Seek Professional Help
Don’t wait if you notice orthodontic problems. Early evaluation and treatment often lead to better outcomes and less complex treatment.
Schedule a Consultation If You Notice:
In Children:
- Permanent teeth coming in crooked
- Difficulty chewing or biting
- Mouth breathing or snoring
- Speech difficulties
- Thumb sucking past age 4-5
In Teens and Adults:
- Crooked, crowded, or gapped teeth
- Jaw pain or clicking
- Difficulty cleaning teeth properly
- Bite problems when chewing
- Self-consciousness about your smile
What to Expect at Your First Visit
Most orthodontists offer complimentary initial consultations that include:
- Examination of teeth, bite, and jaw alignment
- Discussion of any concerns or problems you’ve noticed
- X-rays if needed to see tooth roots and jaw structure
- Treatment planning discussion if treatment is needed
- Cost and payment options review
Maintaining Results After Treatment
Orthodontic treatment doesn’t end when braces come off or you finish your last aligner.
The Importance of Retainers
After active treatment, teeth naturally want to move back to their original positions. Retainers hold teeth in their new, correct positions while the surrounding bone and tissue stabilize.
Types of Retainers
Removable Retainers:
- Hawley retainers (wire and acrylic)
- Clear plastic retainers (similar to aligners)
Fixed Retainers:
- Thin wire bonded behind front teeth
- Stay in place permanently
- Most common for lower front teeth
How Long to Wear Retainers
- First year: Full-time except for eating and brushing
- After first year: Typically nights only
- Long-term: Many orthodontists recommend lifetime nighttime wear
Final Thoughts
Orthodontic problems are common, but they don’t have to be permanent. Whether you’re dealing with crowded teeth, bite issues, or gaps between teeth, modern orthodontic treatments offer effective solutions that fit your lifestyle and budget.
The key is early detection and timely treatment. By taking your child to see an orthodontist around the age of 7, you can detect potential problems early, allowing for prompt and effective treatment that can save money down the road. For adults, it’s never too late to achieve the straight, healthy smile you’ve always wanted.
If you’re ready to explore your orthodontic treatment options, we invite you to schedule a consultation with Dr. Vanderstelt at aligned. Orthodontics. Our modern approach combines the latest technology with personalized care to help you achieve your best smile. Contact us today to take the first step toward a healthier, more confident you.
Remember, a beautiful smile is an investment in your health, confidence, and future. Don’t wait to give yourself the gift of straight, healthy teeth that will last a lifetime.