Crowding

A mismatch between the size of the teeth and the size of the jaw. If the teeth are larger than the arch can hold, they overlap, rotate or get pushed out of line. Both tooth size and jaw size are largely inherited.

It is not caused by anything you did, and it is not a sign of poor dental care. More on our crowding page.

Space has to come from somewhere, and there are three sources: expanding the arch slightly, reducing the width of teeth by a fraction of a millimetre each where appropriate, or removing teeth where the shortage is severe.

Which applies depends on how much space is missing and on your facial profile. Mild crowding is often straightforward with clear aligners. Severe crowding, and anything involving extractions, is usually better handled with fixed braces, which give more control over root position.

Frequently, yes. Mild and moderate crowding is usually treated without removing anything, by widening the arch a little and by interproximal reduction, which shaves a fraction of a millimetre from the sides of teeth to create room.

Extractions come in where the shortage is severe, or where taking teeth out gives a better facial result than pushing the front teeth forward. We do not extract as a matter of routine, and we will explain the reasoning if we recommend it.

Orthodontists measure it as the difference between the space available and the space the teeth need. Roughly speaking, a shortage of a couple of millimetres is mild, up to about four is moderate, and beyond that is severe.

What matters more than the label is what it takes to fix. Severe crowding is the category where extractions become likely, and where fixed braces generally outperform aligners.

Yes, particularly the lower front teeth, and it happens to people who had braces as well as those who never did. This is normal age change rather than anything going wrong.

It is the reason retainers are a long-term commitment, and the reason waiting to see whether crowding settles down on its own is not a strategy that works.

Usually it does not feel like anything, which is part of the problem. Crowding is normally noticed visually rather than through discomfort.

What people do notice is practical: floss shredding or refusing to pass between certain teeth, food catching in the same spot, a tooth that feels like it sits proud of the others, or particular teeth that are always harder to brush and stain more quickly.

It depends entirely on which one. Mild crowding or spacing may cause nothing worse than teeth that are harder to clean. A deep bite, a crossbite or a large overjet are different, because each causes progressive damage: enamel wear, gum recession, or a jaw habitually displaced to one side.

The honest answer is that some bite problems are worth living with and some are not, and only an examination will tell you which you have. There is more on our problems we treat page.