Overcrowded Teeth: Why and How to Fix Them

Overcrowded teeth affect appearance, smile, and, thereby, self-esteem. However, with advances in modern dentistry, this overcrowding is correctable. Let’s discuss some common causes of the overcrowding of teeth and treatment options.

Key takeaways:
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    In overcrowding of teeth, teeth are mispositioned, which leads to symptoms such as difficulty in speaking and eating.
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    Genetic factors and other disorders cause overcrowding of teeth.
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    Extraction and braces are two common treatment options for the overcrowding of teeth.

Overcrowded teeth are malpositioned teeth due to a lack of coordination and space in the jaw. As a result, teeth rub together unevenly, causing the teeth to stack up on top of each other. Side effects, such as dislocation, rotation, and eruption of teeth, can occur when there is insufficient space for tooth alignment. Overcrowding can be caused by a narrow jaw space, an increase in the space between teeth, or a combination of both.

Various factors cause overcrowded teeth, including genetic and environmental factors. Here we discuss the four most common ones.

Genetics

The shape and size of a jaw are linked to genes, and it affects the growth of teeth. If the jaw does not have enough space, then the teeth can be bent and crowded. A study noted that heredity influences dentofacial development. Up to 40% of patients with misaligned teeth may have inherited the condition.

Another study examined the role of genetics in crowding teeth in indigenous populations from two villages. The results indicated that the role of food eaten was not as predominant as previously thought. However, genetic causes exacerbated dental crowding due to inbreeding.

Marfan syndrome

Marfan syndrome, a disorder of the connective tissue, leads to the occurrence of overcrowded teeth and imperfect dentinogenesis. Orthodontic and skeletal abnormalities are the hallmarks of this syndrome. Patients with Marfan syndrome have a narrow upper jawbone that causes crowding of the teeth. Posterior crossbites usually result from a narrow and high palate.

The main cause of Marfan syndrome is a mutation in the fibrillin gene (FBN) 1. Most patients with Marfan syndrome are referred for orthodontic treatment due to overcrowded teeth. Patients with Marfan syndrome also tend to have inflammation caused by overcrowded teeth.

Crouzon's syndrome

In addition to Marfan syndrome, the crowding of teeth can also be observed in Crouzon syndrome. It is a disorder caused by mutations in a specific gene — the fibroblast growth factor receptor 2 (FGFR2) gene. The hallmarks of Crouzon syndrome are overcrowding of upper and lower teeth, V-shaped maxillary dental arch, and bulging mandible (lower jaw). Additionally, patients with this syndrome have a higher, more narrow cleft palate.

Osteopathia striata with cranial sclerosis

Osteopathia striata with cranial sclerosis (OSCS) is defined as a dominant X-linked condition affecting the size of the head and facial features. Females are affected more severely than males as a specific gene — the WTX gene (FAM123B) — is involved. Furthermore, the hallmark of OSCS is the presence of altered facial features, which include overcrowded teeth, a high-arched palate, a depressed nasal bridge, and an abnormally wide distance between two orbits of the eye.

Symptoms

Overcrowded teeth and misaligned jaws can lead to jaw muscle fatigue. The jaw muscles work harder when they don't have much space, coupled with the presence of overcrowded teeth. It triggers fatigue and spasms of the jaw muscles. This condition produces persistent migraines, sinus pain, and back and shoulder pain.

Furthermore, significant symptoms of severely overcrowded teeth are difficulty speaking, changes in facial appearance, crossbites, and frequent tongue biting during speech and chewing. Overcrowded teeth can also lead to the accumulation of bacterial biofilm and cavities. It can increase the risk of systemic diseases such as endocarditis.

How to fix overcrowded teeth

The lack of self-confidence in social situations of patients with overcrowded teeth usually prompts them to seek appropriate treatment. Several associated factors, such as impacted teeth, gum disease, cavities, and other medical disorders, must also be considered to obtain the expected therapeutic output.

The main goal of overcrowded teeth management is to improve the facial shape, align teeth, achieve proper spacing and contact of the front teeth, and maintain oral hygiene. Overcrowded teeth can be corrected through braces, Invisalign treatment, scaling, root planing, and tooth extraction. Alignment and alignment of teeth can be done through the installation of braces. Metal or ceramic braces can treat crowding with mild to moderate severity.

For patients who are not confident when using colored braces, Invisalign can be the right solution. It is a clear aligner that can correct the crowding of teeth. The speed and efficiency of aligner therapy are ideal for adolescent and adult patients with overcrowded teeth.

In some cases, surgery may be necessary. A study indicated that overcrowded teeth repair could be achieved through a combination of surgery to cut, break, or reshape the jaw (corticotomy) and orthodontic treatment. Corticotomy-assisted orthodontics is a procedure that helps speed up bone metabolism and the movement of teeth into their proper position. The treatment, carried out for eight months, successfully overcame overbite in patients with overcrowded teeth2.

Malocclusion of teeth can be due to genetic factors and diseases such as Marfan syndrome. This condition can affect appearance and functions, including biting and chewing. Extraction of teeth and braces or clear aligners can help persons with overcrowded teeth. Consult with your dentist regularly to monitor the progress of overcrowded teeth treatment.

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