Ideally, the teeth are flat, located at regular intervals, and the size that matches the jaws exactly. The ideal relationship between upper and lower teeth in a closed condition (called occlusion) is that in which the upper teeth project slightly above the lower and the peaks of the molars are placed alternately.
However, few people have perfect teeth, apart from the fact that everyone inherits different characteristics from their parents. If, for example, the teeth are too large for the jaw, tooth narrowing occurs and they can only develop by folding backwards or “across” the adjacent teeth. If the teeth are too small for the jaw, the space between them will be too large. If the lower jaw is smaller than the upper one, and if the lips are too small, the teeth in the upper jaw will sometimes stick out (sometimes called defective occlusion or malocclusion).
However, hereditary factors are not the only cause of teeth irregularity. Narrowing is sometimes a consequence of premature loss of baby teeth due to bleeding. If, for example, deciduous molars are lost early, the gaps in the jaws will be filled with permanent molars. For this reason, permanent premolars and canines, which occur between the ages of 11 and 13, will be displaced from the natural dental arch. In addition, in some cases the teeth do not appear at all.
Teeth narrowing, which occurs when the permanent teeth appear, is sometimes only temporarily. This is especially true for the lower front teeth, because the jaw often grows enough to give teeth more space.
There is a great risk of tooth decay (caries) and gum disease because narrow teeth are harder to clean.
At least a third of young adolescents are using a correction for narrow teeth, which makes them easier to clean their teeth and gums, chew food more effectively and, finally, to improve the overall appearance.
What to do?
If you are an adult with a minor problem – e.g. with a few narrow or distorted teeth – the dentist will probably tell you that the condition can only be corrected with much time and effort. If the problem is serious, you will have to reconcile with the fact that there is no easy solution. If you have psychological problems due to the appearance of the tooth, you may agree to a larger operation (or several of them) to correct the condition. On the other hand, you can reconcile with it, remembering that some people are good and with much more difficult problems.
If you notice any misalignment – or any other problem with the teeth – in children, be sure to take them to the dentist. Treatment will be most successful in childhood and early adolescence when teeth and jaws are still growing and developing.
If the children are having problems with the teeth, help them to help themselves. As always, the whole family must take care of their teeth (see the article tooth decay) by following instruction about tooth and gum hygiene. For all other problems, you need to go to a dentist – a specialist in correcting various teeth irregularities.
The dentist will take X-rays to record the jaws and to see if all the permanent teeth are properly formed and assess the likelihood of their appearance. If there is a risk of compression (narrowing), one of the possible solutions is to extract the adjacent tooth, which has already appeared, to create space for the new tooth.
The basic procedure in the case of improper teeth is the use of a special dental apparatus in the course of several months. The apparatus (often referred to as the “plate” or “denture”) is fixed so that it is firmly fixed around several teeth. The apparatus often includes springs that are constantly pressed against the tooth, spinning it, or pushing it forward or backward, or laterally into the jaw (as per the case), to achieve the correct alignment.
The procedure is most successful in childhood and adolescence. Underneath the apparatus can be a dental plaque, so the person carrying the apparatus must pay particular attention to the thorough cleaning of the tooth and the apparatus after each meal.
Apparatus are often used in children with protruding upper incisors, as well as pronounced canines. In such cases, the dentist will take dental impressions and, with an X-ray, record places where the tooth should appear. In children, it may be necessary to remove several premolars before setting up the apparatus that will move the canine teeth to the correct position. After that, a new apparatus is placed; it pushes the upper incisors backwards so that there is no gap between them and the canine teeth. These procedures are applied between the ages of 10 and 13, lasting up to 24 months, and require persistence in both the child and the parent.
As a final part of the procedure, another apparatus is installed – the so-called ”retainer” – which needs to be carried for 6 to 18 months. This apparatus keeps the teeth in a new place until the bone around them is hardened. In adults with minor problems, a combination of tooth extraction and apparatus is used. However, as the child quickly adjusts to wearing the apparatus, such devices bother most adults, and the treatment lasts longer in a mature, hard jaw.
If you are an adult and feel psychological stress due to compression or malocclusion (incorrect setting of the tooth), a corrective surgical procedure may be undertaken with the repositioning of the jaw parts and some teeth.