Braces are a highly effective method for correcting front teeth that appear to stick out, a condition technically known as “overjet” or “dental protrusion.” This involves the upper front teeth extending too far horizontally past the lower front teeth. While the appearance of “big” front teeth is the primary concern, this misalignment affects biting, chewing, and long-term oral health. The following sections explore the causes of this condition, the specific mechanisms braces use to correct it, and the other treatment options available.
Understanding Dental Protrusion
The appearance of front teeth sticking out is typically a result of overjet, the horizontal overlap measurement between the upper and lower front teeth. An overjet exceeding the normal range of two to four millimeters is considered excessive protrusion. This alignment problem, a type of malocclusion, can increase the risk of trauma to the upper incisors and cause difficulties with lip closure and speech.
The cause of dental protrusion often dictates the complexity of treatment. In a purely dental protrusion, the teeth are angled forward within a correctly sized jaw structure. This issue is frequently caused by childhood habits like prolonged thumb-sucking or tongue thrusting, which exert continuous pressure on the developing teeth.
A more complex scenario involves skeletal protrusion, where the misalignment stems from a discrepancy in the size or position of the jawbones. This means the upper jaw is positioned too far forward or the lower jaw is positioned too far back. Correcting skeletal protrusion in a fully grown adult requires a more involved treatment approach than a simple dental protrusion.
How Braces Reposition Front Teeth
Traditional braces correct dental protrusion by applying continuous, gentle force to retract the upper front teeth backward into the dental arch. The system consists of brackets bonded to each tooth and connected by a wire, which guides the teeth into their new positions. This movement relies on the biological process of bone remodeling, where bone tissue is dissolved on the side of pressure and rebuilt on the side of tension.
Anchorage refers to the stable base of resistance used to move the protruding front teeth. The back molar teeth often serve as the primary anchorage unit. To enhance this resistance, orthodontists use elastics or springs, connecting the upper front teeth to the anchored back teeth to pull the protruded teeth posteriorly.
In cases requiring maximum retraction, Temporary Anchorage Devices (TADs) may be used. These small, temporary screws are placed in the jawbone to provide an immovable point of resistance, ensuring the back teeth remain stationary while the front teeth are pulled back. The combination of brackets, wires, and directed forces allows for the precise control needed to reduce the horizontal overjet.
Alternatives to Traditional Braces
While traditional braces are reliable for correcting protrusion, several alternatives exist depending on the extent of the misalignment. Clear aligners, such as Invisalign, are popular for patients with mild to moderate dental protrusion. These removable trays use custom-made molds to gradually shift the teeth, offering a less noticeable treatment option.
For younger patients whose jaws are still developing, early orthodontic intervention (Phase 1 treatment) can modify jaw growth. Devices like headgear or functional appliances can restrain the growth of the upper jaw or encourage the forward growth of the lower jaw. This reduces the severity of protrusion before all permanent teeth erupt.
If the protrusion is caused by a significant skeletal discrepancy in a mature adult, braces alone are insufficient. In these situations, the treatment plan often includes orthognathic surgery, which involves repositioning the upper or lower jawbone for proper alignment. This surgery is typically performed in conjunction with braces, which finalize the precise positioning of the teeth within the newly aligned jaws.
Maintaining Your New Smile
Once the front teeth are moved into position and braces are removed, the retention phase begins to ensure long-term stability. Teeth have a natural tendency to shift back toward their original positions, known as relapse. This occurs because the surrounding bone, gum fibers, and ligaments require time to fully adapt to the new tooth location.
The two main types of retainers are fixed and removable. Fixed retainers are thin wires bonded to the back surface of the front teeth, providing continuous stabilization that is invisible from the outside. Removable retainers, such as clear plastic trays or Hawley retainers, are worn full-time initially and then transition to nighttime wear.
Consistent, long-term retainer wear is necessary to prevent relapse. The orthodontist provides a specific wearing schedule, but many patients are advised to continue nighttime wear indefinitely. Skipping the retention phase risks undoing the progress and investment of the entire orthodontic treatment.