hey it's dr amanda with straightsmilesolutionstreetsmilesolutions.com
and today we're going to be doing an educational video much like the one that we also posted today
about different types of tooth movements and what it looks like and today we're going to be
talking specifically in this video about crowding and maybe you've maybe you are a patient maybe
you're a consumer maybe you've been to the dentist the orthodontist and they've talked to you about
different ways if you have crowding so let's talk about the pros and cons and what these different
movements look like so crowding is most often a result of having incompletely grown jaws jaws that
didn't grow the right width or jaws that didn't grow forward enough on the base of your skull
and this is the result of either not breastfeeding not breastfeeding long enough as a baby
having a soft or processed diet in tribal cultures or in cultures primitive cultures even now
and there's been many studies that have gone back hundreds if not thousands of years
that are seeing this where people who have more primitive diets you know they go from
exclusively breastfeeding for one to two years as a baby to eating hard and crunchy foods meat
ripping the meat off the bone no they don't have you know knife and fork they're chewing they're
grinding they have a very um abrasive diet with a lot of sand and dirt in it and that actually
helps the jaws grow wider and more forward it gives you a better airway it also helps you not
have crowding and most of these cultures there is no crowding it's really primarily a first world
problem that every generation it's finding it's getting worse and worse and worse as well as
our airways are getting smaller so anyways that's just a little bit of science for you
but what are we going to do about it right you already have crowding now we got to fix it okay
so not that hard to fix okay different ways to fix it so let's talk about the more natural ways
which would be either expanding an arch okay like this the more you expand and arch the crowding
goes away okay now we have some spacing or you can also grow a jaw you have to do that obviously with
jaw surgery if the child isn't growing anymore if it's an adult okay or you can extract teeth
probably should done that one last or you can do something called interproximal reduction
which means just sawing in between the teeth a little bit to eliminate the um some of the
width just a teeny bit a sliver that actually works very similar to how having it sandy or
abrasive diet would work when you chew the sand gets in between your teeth and wears it down
very similar very natural or you can tip the teeth forward on the jawbone a little bit
or you can distilize or move the teeth backwards that actually makes your airway a little smaller
so it's not really my first choice but in some people that does work okay either way that's
going to give us no crowding hopefully the space we need to line all the teeth up nicely
and that's pretty much your options for crowding there obviously things you have to think about
limitations right growing jaws the only way you're going to grow a jaw is if there's a
still growing child before they finish puberty or an adult with jaw surgery right so that might be
off the table if you're 20 or something unless you have 50 grand for jaw surgery um what else
distalization scooting things backwards we can do that but not if there's impacted wisdom teeth
or even erupted wisdom teeth because you don't have room in the jaw bone for that so that worked
well if you had your wisdom teeth extracted that's an option moving teeth forward or tipping them
out or proclination you see that most common in aligners or braces but that only works you know
depending on your jaw bone so if your bone isn't thick enough here let's say you have let's say for
example you have like okay we're doing like we're totally ruining this let's say we have no bone
anterior or forward to these teeth if we try to tip them forward what's going to happen
well the roots are going to come outside the bone and that tooth is going to devitalize
and it's going to die and or get loose and fall out so you can't do that necessarily in
all patients you have to measure the bone you can measure it clinically by examining a patient in
person you can measure radiographically you know by taking a cone beam ct scan sometimes i can kind
of see it in a set x-ray which is sometimes why we take those x-rays for orthodontics
sometimes you can see it in pictures too so that's another way as well but that is how
you know about proclination we talked about distalization obviously extraction not my
first preference i don't want to kill teeth pull them out that's the bottom of the list
ipr or slenderization nice that's a good option as long as you don't have like crowns or veneers
or interproximal fillings that probably not gonna work it's only gonna work on natural teeth
um yeah and definitely widening of the jaw you can get some winding a little bit just
with arch wires and aligners but like i said there's a limitation to the bone
in a child who hasn't finished puberty the upper jaw can be split with a palatal expander we are
actually literally breaking the jaw okay they're not they don't feel anything they really don't
because they're they're sutures it's like almost like a baby they're still very spongy and it's a
very gradual process so they don't notice that you're breaking it but you are breaking it um
and you're expanding it and then the lower arch will kind of develop to match sometimes
we expand the lower just to get too big but you can adults it's a jaw surgery for the most part
either with implants that are grilled in the jaw or they actually go in and cut the jaw um there
are a lot of risks for that any of these type of quote-unquote adult expanders it's not something
that is for the faint of heart i would only do it with an oral surgeon and an orthodontist who are
very experienced with these surgeries or appliances because there is a lot of side
effects that can happen a lot and i've seen them from hemorrhage to death the vitalization of
teeth and nerves facial numbness so i think you have to be very it's considered a very serious
type of procedure if you're going to do that it isn't someone that i personally i might get a lot
of hate emails from this but i wouldn't just do it with your local dentist it's not a great idea
so um to be honest i've only done a few of these surgeries in my lifetime you know with
oral surgeons i don't do the surgery but i've assisted on the surgery and i've had patients
that had him it is a rough procedure but it turns out great you know it turns out great
so all right hopefully that was helpful thank you so much for listening today