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The Whys and When of Tooth Alignment

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girl wearing dental braces

A growing number of people are being diagnosed with mis-aligned teeth worldwide (known as malocclusion) There are various reasons for poorly aligned teeth including a

discrepancy between the size of teeth vis-à-vis the size of the jaws- leading to a situation where teeth get crowded and rotated and even fail to grow due to lack of space within the jaws.

Another major reason is the relationship of the upper and lower jaw may be abnormal such that the relationship between upper and lower teeth is poor. These two broad categories are termed as Dental Malocclusion and Skeletal Malocclusion respectively and the cause is usually genetic, but also some habits such a thumb-sucking or tongue thrusting may lead to the same.

What problems come about as a result of poor tooth alignment?

  1. Poor Appearance: By far the most common reason people seek to align teeth is to improve their appearance. Crowding of the front teeth especially is seen as not pleasing to look at and may cause one to have low self-esteem and be unwilling to smile. This could definitely affect one’s ability to socialize and interact with people.
  2. Poor Speech: There are forms of mal-aligned teeth that affect one’s ability to speak certain letters or form certain words. 
  3. Inability to chew properly: Certain forms of malocclusion such as open bite can make it difficult to chew or reduce chewing efficiency
  4. Inability to effectively clean one’s teeth: Crowding makes it difficult to properly clean all the surfaces of teeth. This promotes plaque and tartar build up and encourages gum disease as well as dental caries.
  5. Gum disease due to trauma from biting: Teeth can sometimes be positioned such that they exert excessive forces on the opposing teeth during chewing. This brings about what is called ‘trauma from occlusion’. When this happens, the support structures of the traumatised teeth can get destroyed, leading to lose teeth and receding gums.


It is clear then that aligning teeth is an important part of maintaining good oral health. There are varying degrees of malocclusion from mild, moderate to severe. There are also different modalities for treating malocclusion depending on severity and cause. These modalities include:

  1. Surgery
  2. Myofunctional/growth modifiers
  3. Fixed brackets
  4. Removable Appliances
  5. Interceptive Orthodontics
  6. Clear aligners


I will highlight interceptive orthodontics because it relates to prevention. This is done particularly for children who still have all or some of their ‘milk teeth’. It includes placing habit breakers to break thumb-sucking and tongue thrusting habits; Extracting some milk teeth or permanent teeth so as to give room for other erupting permanent teeth; Placing space maintainers to preserve space where ‘’baby molars’’ are extracted too early and so on. Such measures will reduce or eliminate the need for further intervention.

Finally I will mention that clear aligners are gaining popularity because they are braces that are virtually invisible. They allow adults who are unwilling to have the normal metallic brackets- due to their conspicuous appearance- an option to align their teeth.
Talk to your dentist about which option is suitable for your particular case.

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