Braces are a highly effective and common method for correcting buck teeth, which orthodontists refer to as excessive overjet or Class II Malocclusion. This condition is characterized by the horizontal protrusion of the upper front teeth beyond the lower front teeth. Braces work by applying gentle, continuous forces to safely reposition the teeth within the jawbone through a biological process. This treatment improves the appearance of the smile and addresses functional concerns like difficulty chewing, speech impediments, and increased risk of dental injury.
Understanding Malocclusion and Protrusion
The term “buck teeth” is the common name for a dental condition clinically classified as an overjet or Class II Malocclusion. This occurs when the upper jaw and teeth are positioned significantly forward relative to the lower jaw and teeth, creating the characteristic protruding appearance. Protrusion often stems from a combination of hereditary and environmental factors. Genetic predisposition plays a significant role, as the size and shape of the jaws are inherited traits that can lead to a skeletal discrepancy. Environmental factors, particularly prolonged childhood habits, can also contribute. These habits include chronic thumb sucking, extended use of a pacifier, or a persistent tongue thrusting reflex that exerts continuous forward pressure on the front teeth.
The Mechanics of Braces for Correction
Braces correct protrusion through bone remodeling, which is activated by the constant, controlled pressure they apply. Each tooth is anchored in the jawbone by the periodontal ligament, a dense network of fibers. The components of the brace system—brackets, archwires, and elastics—exert precise force on the tooth crown.
When pressure is applied to one side of the tooth root, it compresses the periodontal ligament against the alveolar bone. This compression signals specialized cells called osteoclasts to migrate to the area. Osteoclasts begin bone resorption, dissolving the bone tissue to create a path for the tooth to move.
Simultaneously, the opposite side of the tooth root experiences tension. This tension activates osteoblasts, which are bone-forming cells. These cells deposit new bone material, solidifying the tooth’s new position. The archwires, often made of nickel-titanium or stainless steel, guide the teeth backward (retraction) as the bone remodeling cycle progresses. Specific elements like power chains and Class II elastics are often attached to the brackets to generate the necessary force for retraction.
Alternative and Adjunctive Treatments
While traditional braces are highly effective, treatment for protrusion can involve several alternative or complementary methods depending on the severity and the patient’s age. Clear aligners, such as Invisalign, are an option for correcting mild to moderate protrusion. However, their ability to perform complex root movements and significant retraction for severe overjet is limited compared to fixed braces.
In growing patients, often those between the ages of seven and eleven, functional appliances or headgear may be used as a first phase of treatment. These appliances modify skeletal growth by encouraging the forward growth of the lower jaw or restricting the forward development of the upper jaw. This early intervention can simplify the second phase of treatment with fixed braces later on.
For complex cases, especially those with significant dental crowding, the orthodontist may recommend tooth extractions. This usually involves removing one or two premolar teeth to create the necessary space to retract the prominent front teeth. In severe cases involving a significant mismatch in jaw size (skeletal discrepancy) in adults, orthognathic surgery may be required to realign the jaw structure before or in conjunction with orthodontic movement.
Treatment Timeline and Retention
The duration of orthodontic treatment varies based on the severity of the protrusion and the complexity of the underlying skeletal issue. Most patients with a Class II Malocclusion can expect to wear fixed braces for 18 months to three years. The speed of tooth movement is limited by the biological rate of bone remodeling, which cannot be safely rushed without risking damage to the tooth roots.
Once the teeth have reached their ideal positions, the final and most important phase is retention. Without retention, the teeth have a natural tendency to relapse, or return to their original position. This relapse tendency is due to the elastic memory of the stretched periodontal and gingival fibers.
Retention typically involves the use of fixed or removable retainers to hold the teeth in place while the surrounding bone and soft tissues reorganize. A common strategy involves a fixed retainer bonded to the back surface of the lower front teeth, combined with a removable retainer for the upper arch, such as a Hawley or clear plastic retainer. The long-term outcome relies heavily on consistent retainer use, often for an indefinite period, to ensure the new smile remains stable.