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Understanding Tooth Movement

Before getting braces, patients typically want to know how long their treatment will take. The answer depends on the time needed to guide the teeth into the correct positions. If you could watch this process, you would discover that moving the teeth isn’t as simple as it might seem. Teeth don’t move in isolation. Because they are connected to the jaw, their movement affects the surrounding bones and tissues. The orthodontist carefully adjusts your braces to control the force so that it’s just the right amount to move your teeth at a safe and effective pace.

Wearing braces entails a deliberate manipulation of the teeth. However, even without braces, your teeth will move throughout your lifetime. The periodontal ligament is constantly reshaping, and the teeth find more freedom to move around as it does. Several factors can influence how much your teeth will shift.

Age

As our bodies age, so do our smiles. Even if you had straight teeth all your life or achieved the perfect alignment with braces, your teeth will begin to shift after age 40. There are a number of ways that aging can change your smile.

The wear, tear and enamel erosion that occurs over time thins our teeth, giving them more space to wander. The lower jaw continues to grow as we age, and the bottom teeth become less able to withstand the force of the top teeth when biting down. The lips become tighter too, placing more external pressure on the teeth. For some people, the muscles in the front of the mouth weaken, which decreases support. Therefore, most people will either begin to see the top teeth spacing out, the lower teeth becoming crooked, or both.

Although you might have once believed you would never sit in the orthodontist’s chair again, orthodontics for adults is extremely common. According to the American Association of Orthodontists, the number of adults seeking treatment is at an all-time high with one in three patients being older than 18. Orthodontic treatment can compensate for teeth shifting even at a later age.

Dental Health

Having multiple cavities filled can increase your chance of tooth movement. The filling used to repair cavities can cause changes to your teeth and occasionally your bite. However, that does not mean you should avoid treating cavities. They can penetrate the gums and eat away the bone that holds the teeth in place, ultimately costing you your teeth. Gum disease also can cause tooth movement, especially in its more advanced stages where the bones and soft tissues that hold the teeth in place start to break down.

People who take good care of their teeth are less likely to experience tooth movement (though genetics and other factors play a role as well). This is because regular brushing and flossing removes trapped food and bacteria that could cause deterioration of the gums and bones. If you start to notice that your floss slides in and out between certain teeth without resistance—or food collects between them—you should talk to your orthodontist, as this could be the beginning of a shifting tooth.

Professional cleanings help dislodge trapped bacteria and remove decay around the teeth that a standard toothbrush and dental floss cannot. During your cleaning, the dentist also will assess the health of your smile, so that either she or your orthodontist can quickly correct any problems at an early stage. The number of times per year you need a cleaning will in part depend on your overall dental health. The dentist will direct some patients to come in twice a year, and others three or four times.

TMJ Disorders

Disorders of the temporomandibular joint can lead to mechanical or behavioral functions that are likely to increase tooth movement. The TMJ acts like a hinge that connects your skull and your jawbone. Pain or disorder specifically related to the temporomandibular joint is commonly known as TMJ, while TMD refers to disorders that occur anywhere along the jaw, jaw joint, or surrounding muscles.


Symptoms typically include:

  • Achiness on the face or jawline
  • Soreness in or near the ear
  • Tenderness of the jaw
  • Locking of the joint, preventing the opening or closing of the mouth
  • Pain while chewing
  • Clicking or grating when the mouth is opened

If you place asymmetric pressure on your teeth over time due to pain or limitation, your teeth will gradually respond to that force, shifting slowly out of alignment. Many people with a TMD disorder often have misaligned teeth prior to their diagnosis, and without treatment tooth movement can affect the misalignment even more.

Orthodontic Treatment

Braces move the teeth by exerting a mild, but constant, force against them. The supporting ligament surrounding the roots stretches on one side of the force and compresses on the other, allowing the teeth to loosen. This stimulates the bone in the path of movement to break down so the teeth can move in that direction. After the teeth have moved, the bone rebuilds to support their new positions.

With traditional braces, the archwire applies pressure and the brackets guide movement. Invisalign works in the same way, with the aligners creating the pressure and guiding the movement. Each time your orthodontist adjusts the archwire or hands you a new aligner, the force and direction of the teeth change slightly to allow them to continue to move in a desired pattern.

While you are wearing braces, an orthodontist carefully controls and calibrates all adjustments to ensure the proper movement of your teeth. After braces, your teeth are not completely settled into their new positions until the gums, bones and muscles adapt to the change. The teeth need time to anchor into their new positions or they will quickly revert to their former placements.

To prevent post-braces movement, the orthodontist will prescribe a retainer, which fits over your teeth with just enough pressure to hold them. Most likely, your orthodontist will fit you for a removable retainer, which he typically will ask you to wear most of the time for the first few months and subsequently at night. Fixed retainers also are an option depending on your treatment plan. At first, your retainer might cause discomfort or pressure on your teeth. This will resolve as your mouth adjusts to the appliance.

Grinding And Clenching

Grinding and clenching your teeth (either at night or throughout the day) leads to tooth movement, as the continual thrusting pushes the upper arch out of alignment. If you are grinding or clenching at night, your dentist may need to create a mouthguard for you to wear during sleep. Mouthguards are made of a thin, plastic material similar to your retainer. However, mouthguards are more durable than retainers, so you might need to wear one in addition to your retainer if you experience significant grinding and clenching at night.

Posture

If you have a desk job, poor posture actually can lead to tooth movement. This is because many people rest their chin in their hands as they slouch toward their computer screens. This might seem innocuous enough, but if you do it regularly over a period of months or years, the slight pressure may actually move your teeth. Make sure your desk does not sit too high or low, that your computer screen is not too far from you, and that your chair has back support.

Are you interested in starting orthodontic treatment? Contact us today to schedule a free consultation with one of our board-certified orthodontists.

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