While it is technically possible to place braces on your top teeth only, this approach, known as single-arch treatment, is not the standard recommendation for most patients seeking orthodontic correction. Orthodontic treatment involves more than simply straightening the teeth that are visible when you smile; it is fundamentally about creating a stable, functional relationship between the upper and lower jaws. Deciding to treat only one arch can compromise the overall harmony of your bite, which is the long-term goal of comprehensive care. Your orthodontist will evaluate your entire mouth to determine if single-arch treatment is appropriate for your specific needs.
When Single-Arch Treatment Is Possible
Single-arch treatment is considered appropriate in a limited number of situations, generally when the patient already has a functional bite. These cases often involve minor cosmetic adjustments to teeth that do not significantly interact with the opposing arch during chewing. For example, a patient may only require braces on the upper arch to close a small gap or diastema between the two front teeth.
The treatment may also be used to correct minimal crowding or spacing issues confined strictly to one arch, where the jaw relationship is already correctly aligned. Another specific scenario is a minor relapse following previous comprehensive orthodontic treatment, where only a few teeth have shifted slightly out of place. In all these instances, the primary consideration is that moving the teeth in the treated arch will not negatively alter the way they meet the teeth in the untreated arch.
The Role of Your Bite
Orthodontics revolves around achieving optimal occlusion, which is the term for how your upper and lower teeth meet. A healthy bite ensures that the forces generated during chewing are distributed evenly across all teeth, protecting them from excessive wear. The upper and lower teeth are designed to interlock like gears, and their precise alignment allows for efficient function when you speak or chew food.
Orthodontic planning involves evaluating the horizontal and vertical overlap of the front teeth, known as overjet and overbite, and the side-to-side relationship of the back teeth. Achieving a balanced occlusion is a primary goal because it safeguards the health of the teeth, the gums, and the temporomandibular joints (TMJ). Moving the teeth in one arch inevitably changes this intricate relationship, which is why a comprehensive approach that treats both arches simultaneously is the standard of care.
Potential Issues with Treating Only One Arch
The primary risk of single-arch treatment is the creation or worsening of a malocclusion, or an improper bite. Even minor tooth movement in the upper arch can result in a new, unbalanced contact with the lower teeth, leading to functional problems. For example, if crowded upper teeth are straightened, they often move forward, which can deepen an existing overbite.
An unbalanced bite can cause the teeth to meet incorrectly, leading to uneven wear on the enamel, which may result in chipping or sensitivity over time. The change in jaw mechanics can also place strain on the temporomandibular joints, potentially leading to jaw pain, headaches, or a temporomandibular joint disorder (TMD). Treating only one arch may save time or money initially, but it can necessitate a second, more complex and expensive round of full orthodontic treatment later to correct the bite issues that were inadvertently created.