What’s the Best Way to Straighten Teeth?

What’s the Best Way to Straighten Teeth?

Smiling coupleI get asked this question all the time. Over the years, I have used different approaches to straighten and align teeth. The treatment options I offer a patient depend on the severity of the situation, the patient’s age, and the patient’s primary concerns.

The most common treatment I recommend is to use removable orthodontic plates to develop the shape of the jaws, as this makes room for the adult teeth and prevents the need for adult teeth to be extracted. There is normally a huge improvement with just these plates, but depending on the severity of the problem and the patient’s age [the younger the better!], we will use braces to align the teeth correctly. If we need to use braces, my goal is to have these off within six months as this is just the final cosmetic alignment of the teeth.

The main reason why teeth are crooked or crowded is due to the jaws being underdeveloped or too small for all the adult teeth. The jaws have not grown to their full potential, but I find the best results are achieved when the jaws are widened with plates. This treatment plan straightens teeth and makes a broad natural smile. By removing adult teeth, the problem of underdeveloped or small jaws is not being addressed, and I always prefer to treat the cause and not the symptom.

Because I do not need to wait for all the adult teeth to be present to begin treatment, these plates can be used at a younger age than braces. The advantages of plates are that they can prevent the need for adult teeth extractions. If you start young enough, it makes the treatment much simpler. I successfully treat children as young as four and five years of age with these plates, and they will probably not require any further treatment when they are older. Simpler treatment means less time and less money!

Braces and Invisalign

Using braces is a very common orthodontic treatment. They are very good at straightening teeth, but they are not very good at creating room for crowded teeth. If the orthodontic treatment only involves braces then you will need to reduce the size of the teeth or remove some teeth to allow space for the teeth to be straightened.

A newer type of braces called “Self-ligating” braces can expand the jaws to make room for the teeth and then align the teeth. They reduce need for tooth size reduction or teeth extractions. I have used these and although they work better than traditional braces, my preference is to widen the jaws with plates and then use braces to finish. This results in treatment being quicker as braces can be on for a very long time.

Clear or tooth-coloured braces are also available. They work much the same as the standard metal braces except that treatment time can be longer as they are not quite as good at detailing the tooth positions. They are bulkier than metal braces, and although tooth-coloured, they are still somewhat visible. I use these for adults often, but most people prefer to have the quicker treatment with the metal braces.  Adults wearing braces nowadays doesn’t carry negative connotations as it once did!

Invisalign has become a popular treatment over the past 10 years. The technology of the treatment is very impressive. In my experience, it is a slow method of treatment, and the final result is not as good as other methods. The cost of this treatment is very high, so it is not something I recommend very often. Like braces, it is difficult to relieve the crowding so the treatment often requires the teeth to be reduced in size or some to be extracted to create space to straighten the teeth.

For adults that do not want braces, I commonly use clear aligners [which are made locally to help reduce the costs] after I have expanded their jaws with plates. With this approach, they have worn an invisible plate and invisible aligners to get straight teeth. They will also have a broad natural smile.
Therefore, in summary, my response to the question above would be that, in my opinion, the best way to straighten teeth for the majority of patients is to use removable orthodontic plates to expand the size of the jaws and then to use braces for six months to align the teeth correctly.