| Crowding in Clinton









When a child is around six or seven years of age the upper and lower permanent incisors are usually erupting, and an orthodontist can determine if enough room is available. If the space is inadequate, the permanent incisors will be crowded out of alignment as they erupt into the mouth. If the crowding is moderate-to-severe it is probably best to have the baby canine teeth removed before they would normally be lost. This allows the permanent incisors to erupt into relatively good alignment, and active orthodontic treatment can usually be postponed. This process is called serial extractions, and permanent teeth may need to be removed later before braces are placed, because the bone may not be adequate to support all of the permanent teeth. If the incisors have a mild degree of crowding the baby canines can be shaved a little to give the incisors enough room, or it may be advisable to leave the crowding and correct the incisors later. Click serial extractions for more information.

Some orthodontists recommend dental expansion appliances at age seven or eight to push crowded teeth outward into a larger arch. This process is called arch development and is very appealing to parents, because its proponents claim that it prevents the need for extracting permanent teeth later. Unfortunately scientific studies have shown that arch development is temporary and that the teeth begin moving back to their original positions after the appliances are discontinued. This type of treatment starts at a very young age and continues for many years, and the results are unstable. Dental expansion simply moves the teeth, while palatal (skeletal) expansion moves the bones of the upper jaw apart to widen the jaw and increase the bone available. Palatal expansion is very successful for correcting posterior crossbites, and it also gains more space for alignment of the teeth. Palatal expansion is also quite stable.

One of the goals of orthodontic treatment should always be to provide a result that is as stable as possible, so Dr. Rushing does not utilize arch development. A strange fact about jaw growth is that after the incisors erupt, the amount of bone available between the incisors and molars does not increase as the patient grows. The arches grow in length by adding bone behind the molars. Therefore, early crowding is not resolved by growth of the jaws. Sometimes a small amount of crowding can be corrected by moving the molars back a little, and this does sometimes allow mild crowding to be corrected without removing permanent teeth.

Dr. Rushing treats the majority of patients without removing permanent teeth, but his goal is to treat each patient according to the the patient's individual needs. Be assured that when teeth are removed for orthodontic purposes, the spaces are completely closed by the braces.

Non-extraction treatment is a great disservice to a patient with severe crowding because the final result will be very unstable. When the teeth are over-expanded there will also be a significant potential for gum and bone defects around the teeth.

Below are before and after photographs of some of our patients with crowded teeth that we corrected with braces:

KR, 12 years old, had her severe crowding corrected in 26 months with braces:

KR Before KR After

DG, 13 years old, had his severe crowding corrected in 28 months with braces:


DG Before DG After

DH, 13 years old, had severe crowding and an anterior crossbite which we corrected in 24 months with braces:


DH Before DH After

JS, 14 years old, had his severe crowding corrected in 22 months with braces:



JS Before JS After
Clinton Dentist | Crowding. Evertt Rushing is a Clinton Dentist.

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