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How Invisalign ® and Braces Work for Common Orthodontic Cases

By December 15, 2020February 16th, 2021Orthodontics
invisalign-and-braces-work-for-common-orthodontic-cases

Can Invisalign fix gaps? Will braces work for an overbite? Which treatment option is best for an open bite? To help shed light on some of the questions I get from my El Dorado Hills orthodontics patients about different smile concerns, I put together a guide on the common orthodontic cases and how I treat them using braces and Invisalign®. I’ll be covering everything from what an overbite is to the basics of how to fix a crossbite. While this will hopefully give you a better idea of what your potential treatment options are, the only way to receive an accurate diagnosis and determine the best treatment for your individual needs is to visit an orthodontist

What is Crowding?

Crowding happens when there isn’t enough room in the jaw for all of the teeth to fit properly. As the teeth attempt to squeeze in, they might rotate, twist, overlap or shift in the wrong direction. Crowded teeth can be genetic and related to the size of the teeth or jaw.  Another common cause of crowding is losing baby teeth too early. One of the main jobs of the baby teeth is to save space for the permanent teeth to come incorrectly. If a baby tooth falls out too soon, whether due to injury or decay, the other teeth have a tendency to shift to fill in space, which leads to crowding and can prevent the underlying permanent tooth from erupting in its ideal position. For this reason, a dental space maintainer is usually recommended when a baby tooth falls out before its time. Dental space maintainers have been shown to be highly effective in preventing shifting and saving space for the permanent tooth to erupt.  Having crowded, misaligned teeth impact the appearance of your smile. Since crowded teeth are harder to effectively brush and floss, crowding can also increase your risk of tooth decay or gum disease. Crowding may cause uneven wear of the teeth and make any teeth that are protruding more susceptible to injury as well. 

Using Braces or Invisalign ® for Crowded Teeth

At Jeffrey Kwong Orthodontics, we have great choices to help “sleigh” that snaggle and address your teeth crowding. We use both braces and Invisalign® for crowded teeth. Invisalign® and Invisalign Teen® work by using attachments along with the aligners to help make space in order to move the teeth into their correct places. Invisalign® attachments are tooth-colored “handles” that are bonded to the teeth, giving the aligners something to grip onto for leverage. To achieve more complex tooth movements, other attachments, elastics, or auxiliaries might be necessary.  Orthodontists have been using braces to fix crowded teeth since braces were first invented and they’re still used today for crowding because they’re so effective. In addition to conventional metal braces and clear braces, I’m also the first greater Sacramento InBrace® hidden braces provider and one of only two providers in the region. These behind-the-teeth braces utilize Smartwires™ that are able to create space to eliminate crowding, while also fixing rotations and the angulation of the teeth for super efficient treatment and awesome results

What is Spacing?

Spacing, sometimes called gap teeth, is when there is a gap between two or more teeth. The problem can be caused by genetics, oral habits like prolonged thumb sucking or tongue thrust, missing teeth, or teeth that are just too small or narrow for the size of the jaw. Having gaps between the teeth can make you feel self-conscious, however, it’s more than just a cosmetic problem. Food debris and plaque can build up in the spaces, which can ultimately cause tooth decay and gum disease, and spacing can be a sign of the deterioration of the bones that hold your teeth. 

Using Braces or Invisalign ® for Spacing

Back to the earlier question, can Invisalign® be used to fix gaps? Yes, Invisalign can be used to fix gaps between the teeth. Based on my specific instructions to the lab, each set of aligners is pre-programmed to address how much and how far the teeth should move. As you wear your Invisalign ® aligners, your teeth will shift into place bit by bit and the spaces will close. Braces are also an excellent option for correcting spacing. Clear braces and metal braces will both efficiently and effectively eliminate gaps between the teeth, as will InBrace®. 

What is an Overbite?

An overbite is when the upper teeth are too far in front of the lower teeth. Pretty much everyone has at least a tiny bit of an overbite, but when the distance is greater than about 3mm, it’s a concern for function and trauma. Fixing an overbite is important because this type of malocclusion (improper bite) can lead to uneven wear, jaw pain, and chewing difficulties, and can make the top teeth more likely to be injured. Overbites may be due to the position of the teeth or the size of the jaws and are often genetic. Habits like a tongue thrust or intense thumb sucking can also be culprits. 

Using Invisalign ® or Braces for an Overbite

Many times, if you have an overbite, braces, Invisalign® or other appliances will be effective. In fact, overbites are among the most common bite concerns we treat. When using Invisalign® to fix an overbite, depending on whether the problem areas are in the top or bottom jaw, I plan for the case to address those specific areas to help either shift the upper front teeth back or the lower teeth forward, so that the top and bottom teeth come together properly. Since we need to help with matching the top and bottom teeth in the bite, we commonly use Invisalign® attachments and rubber bands in conjunction with your aligners. When correcting an overbite, braces are a great option too. Metal braces, clear braces, and InBrace® can straighten misaligned teeth and improve your bite. In some cases, when using braces for an overbite, extras, like braces rubber bands, will be needed to get the necessary leverage to achieve certain tooth movements.  There are instances where patients have a severe overbite that is related to the size or positioning of their jaws. Depending on your specific situation and severity of the overbite, we may consider an interceptive phase. This will often be followed by braces or Invisalign Teen® to align the teeth in phase 2. 

What is an Underbite?

An underbite is a type of bite characterized by bottom teeth that sit in front of the top teeth when the mouth is closed. An underbite is more often than not a skeletal issue and occurs when the lower jaw is too far forward and larger than the upper jaw. It’s important to fix an underbite; not only does it cause uneven wear of the teeth, it can also put stress on the gums and bones of the lower teeth as the upper teeth push against them from behind. It makes it hard to chew and speak properly too. 

Using Invisalign ® or Braces for an Underbite

Sometimes, when a patient has underbite braces or Invisalign® treatment can be effective. If an underbite is mild (more tooth position related than jaw position), I can use aligners, along with the attachments and rubber bands I mentioned before, to align your teeth and bite. The same holds true for braces. I may be able to combine InBrace ® hidden braces, clear braces, or metal braces with braces rubber bands to fix an underbite. Other adjunctive treatments like the cosmetic bonding of teeth or resizing the teeth with interproximal reduction might be necessary as well.  It’s important to note that diagnosing and treating an underbite early is usually the key to success and helps patients reduce and hopefully avoid needing underbite surgery later in life. It’s recommended that kids visit an orthodontist for the first time by the age of seven. If I see an emerging underbite at this point, I can manipulate jaw growth with orthodontic appliances while the patient is still growing and developing. Once the jaw-related concerns are addressed, I can then use Invisalign® or braces to align the teeth.  For a severe underbite in adult patients, surgical orthodontics may be the best way to fix an underbite and get stable results. Surgical orthodontics involves corrective jaw surgery to align the jaws and braces or clear aligner treatment to align the teeth. 

What is an Open Bite?

An open bite is pretty much exactly what it sounds like: the teeth don’t touch at all and there is a space or opening even when the jaws are closed. If the back teeth meet but the top and bottom front teeth don’t overlap, it’s referred to as an anterior open bite. If the front teeth come together but the back teeth don’t touch, it’s called a posterior open bite. An open bite can be due to issues with jaw growth or oral habits, including tongue thrust, thumb sucking, and prolonged pacifier use. An open bite often causes certain teeth to wear down and it makes it difficult to bite into foods and chew properly. 

Using Invisalign or Braces for an Open Bite

Clear braces, metal braces, or InBrace® invisible braces can all be effective for fixing an open bite. As I said, InBrace® relies on Smartwires™ that are able to efficiently move the teeth in a number of ways, while also creating or decreasing space, making it a good choice. However, Invisalign® can actually be even more effective than braces for closing an open bite. Aligners move certain teeth at certain times, which is called staging, and staging is a crucial part of correcting an open bite.

What is a Crossbite?

When some of the lower teeth are in front of the top teeth, it’s called a crossbite. If the back upper teeth are behind the back bottom teeth, you’re said to have a posterior crossbite, or back crossbite – think of it as an upside down bite. If it’s the front teeth that are involved, we call it an anterior crossbite, or front crossbite. A crossbite, whether a posterior crossbite or an anterior crossbite, is an indication that the jaws might be too narrow, though it can sometimes be due to misaligned teeth. The problem may be the result of genetics (poor mom and dad taking the blame again!), trauma, certain oral habits, or the premature loss of primary teeth.  When you have a crossbite, it’s not uncommon for you to try to compensate by shifting the jaw to one side. This may create lopsided jaw growth and, ultimately, permanent changes in the facial structure, jaw joints and position of the teeth. Over time, if left untreated, a crossbite can lead to excessive wear of the teeth and bone loss, and have a negative effect on the health of the gums. 

Using Braces or Invisalign ® for a Crossbite

As for how to fix a crossbite, it depends on the severity and the underlying cause. This is another instance where early evaluation can be extremely beneficial. If multiple teeth are impacted and it’s a skeletal issue, intervening while a patient is still growing can allow me to guide jaw growth with an appliance so that the jaws are the proper size. I can use Invisalign ® or braces later to shift misaligned teeth into place. If the crossbite is related to the position of the teeth, which is often seen with a single-tooth crossbite, Invisalign ® could be a viable option. For other patients, using braces for a crossbite along with tools like rubber bands would be a better choice.  As you can see, whether you have crowded teeth or an overbite, braces and Invisalign ® can both be used to correct the problem in many cases. However, with any treatment option, experience matters, and a thorough, personalized treatment plan is needed to get dramatic, lasting results. At Jeffrey Kwong Orthodontics, my team and I pride ourselves on blending our high-tech approach and in-depth treatment planning with open communication to bring out the best in every patient’s smile. If you’re ready to find out if our El Dorado Hills braces or Invisalign ® treatment will work for you, schedule a complimentary consultation at Jeffrey Kwong Orthodontics today!

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