Receiving orthodontic treatment for only the lower arch, known as single-arch treatment, is a common question often driven by aesthetic preference or a desire for a shorter treatment time. The short answer is yes, it is possible to get just bottom braces, but this approach is appropriate only in highly specific circumstances. The decision to treat only the lower teeth is not a matter of simply addressing the most visible misalignment, but rather an assessment of how the two dental arches interact. Orthodontic care focuses on creating a stable, functional, and healthy bite, which requires a comprehensive evaluation of the entire mouth.
Clinical Conditions for Bottom-Only Braces
Orthodontists consider single-arch treatment for the lower teeth only when the existing alignment of the upper arch is already stable and correct. This approach is typically restricted to minor alignment issues, such as slight crowding, minimal spacing, or correcting minor relapse after previous orthodontic treatment. Adult patients who had braces as teenagers often experience minor lower front tooth shifting, making them suitable candidates for this targeted treatment.
The patient must present with a healthy bite relationship, meaning the way the upper and lower teeth meet must be non-problematic before treatment begins. If any significant bite issue, such as an overbite, underbite, or crossbite, is present, treating only one arch is generally not recommended. The upper teeth must have minimal involvement in any existing alignment problem, ensuring that lower tooth movement will not destabilize the overall bite.
A thorough clinical assessment, including X-rays and dental molds, is performed to confirm that the movement needed in the lower arch is solely for cosmetic improvement or minor correction. Orthodontists must be confident that the final position of the lower teeth will harmonize with the untreated upper teeth. If the planned movement risks creating a new malocclusion, the orthodontist will advise against single-arch treatment, prioritizing the long-term health of the jaw joint and teeth.
The Critical Role of Occlusion
Occlusion refers to the intricate way the upper and lower teeth meet when the mouth closes, also known as the bite. This relationship is fundamental to proper chewing function, speech, and the long-term health of the teeth and jaw joints. Orthodontics is not just about straightening teeth for aesthetics, but also about correcting the functional relationship between the arches.
When only the lower arch is moved, the risk of disturbing this delicate balance is substantial. Shifting the lower teeth, even slightly, can alter the contact points where they meet the upper teeth, potentially creating an unbalanced bite. This change can lead to premature wear on certain tooth surfaces, as the forces of chewing are no longer distributed evenly across the teeth.
A destabilized bite can also contribute to more serious issues, such as temporomandibular joint disorder (TMD), which can cause jaw pain, headaches, or clicking in the jaw. Because the teeth, jawbones, and jaw joints function as a single system, changing one component without accounting for the other can result in a problematic outcome. Comprehensive treatment involving both arches is often mandatory to achieve a stable, functional, and lasting result.
Logistics of Single-Arch Treatment
For patients who qualify for bottom-only braces, the treatment duration is often shorter than a full-arch case. Mild cases are sometimes completed in as little as 6 to 12 months, although moderate cases may take up to 18 months. This shorter timeline is a direct result of the limited tooth movement required, focusing on the anterior teeth.
Regarding cost, single-arch treatment is generally less expensive than full treatment, but it is typically not half the price. The cost often ranges from 60% to 70% of the total cost for full braces, which can be an estimated $2,000 to $5,000, while full treatment averages around $5,000 to $6,000. This is because fixed costs, such as the initial diagnostic work, the orthodontist’s chair time, and the final set of retainers, still apply regardless of the number of arches treated.
Long-term retention is a necessary part of all orthodontic care, especially for the lower front teeth. After the braces are removed, a fixed retainer is often recommended to prevent the lower teeth from shifting back into their original position, a phenomenon known as relapse. This retention phase is crucial for maintaining the cosmetic improvements achieved.
Alternatives for Minor Lower Corrections
For minor alignment issues in the lower arch, several alternatives to traditional braces are available:
- Clear aligners are a popular choice and are highly effective for mild to moderate crowding or spacing. Many providers offer “limited” or “express” treatment packages specifically designed for minor movements, which can reduce treatment time and cost.
- Lingual braces are bonded to the back surface of the teeth, making them virtually invisible from the front. While they can be more costly than conventional metal braces, they provide a discreet method for achieving tooth movement.
- Interproximal reduction, or minor tooth reshaping, can sometimes create the small amount of space needed to align crowded teeth without requiring a full bracing system.
- Cosmetic solutions like dental bonding or veneers can also mask minor misalignment, though these options do not actually move the teeth or correct functional issues.