Overcrowded teeth: brace and retainer for severely crowded teeth

When teeth are crowded, there is a mis-match between the size of jaws or space available in the jaws and the number or size of teeth. When teeth are unable to fir in an even row within the available space in the mouth, they go out of alignment, overlap, and appear irregular and crooked.

Some people find this a distressing cosmetic problem which affects their confidence regarding their smile appearance and stops them from showing their teeth when they smile. Apart from affecting self-esteem, crowded teeth could lead to dental problems such as bite and dental function issues, dental decay or gum disease. An orthodontist can fix overcrowding teeth braces and fix overcrowding teeth with Invisalign. However, braces are generally better for crooked teeth. Contact an orthodontist for an assessment and recommendations.

Causes of Overcrowded Teeth

Causes of Overcrowded Teeth

There can be a number of reasons for overcrowded teeth, such as:

  • Genetics/hereditary traits – The DNA of parents contributes to the formation and function of the jaw and teeth, which if incorrect can lead to crowding and other orthodontic problems.
  • Too small upper or lower jaw – When the teeth appear too large, as if there are too many to fit into the gums.
  • Cleft lip and palate – This occurs when a baby is born with a gap in its top lip or when the two plates of the palate forming the mouth do not join properly.
  • Excess tooth development –This occurs when an unusual amount of teeth grow.
  • Mouth tumours – These can affect the formation and function of the jaw, including tooth development.
  • Injury – Fracturing the jaw and re-healing can result in overcrowded teeth.

A medical practitioner can diagnoses the cause of overcrowded teeth and recommend appropriate treatment solutions.

What Are Habits That Affect Teeth?

Certain habits can increase the risk of crowded teeth. Sucking the thumb can widen the space between the upper front teeth and allow back teeth to crowd forward. Sucking the lower lip tends to crowd teeth in the lower jaw. Normally, the tongue places slight pressure on the teeth to push them outward and foster normal development. If a child breathes through the mouth, the tongue may lie farther back and allow teeth to “fall into the mouth.” All of these habits can be corrected with time, practice and careful attention.

Ways Crowded Teeth Can Impact Your Health

Everyone knows that crowded teeth can cause the teeth to become crooked. No one wants a crooked smile, but crowded teeth can do worse things than effect your looks: they can also cause serious health issues.

Here are ways crowded teeth can affect your health:

Periodontal problems

Crowded teeth can cause periodontal problems, such as gum disease. This happens because as the bacteria in the mouth create plaque growth, the gum recedes from the teeth leaving more room for bacteria to grow.

Bad breath

 Crowding of teeth can cause bad breath because as the teeth come closer together, it can make it more difficult to get rid of bacteria which causes bad breath.

Tooth injury

 Crowded teeth tend to make some upper teeth stick out. These teeth are more likely to be injured by chipping or breaking in the event of an accident.

Tooth wear

 Crowded teeth can cause certain teeth to wear faster than others as some teeth end up doing much more work and others none at all.

Gastrointestinal issues

 Crowding can cause gastrointestinal issues such as heartburn when it leads to bad chewing habits. The food does not get digested as well, which can lead to heartburn and even acid reflux if left unchecked.

Difficulty in Brushing and Flossing Teeth

When the teeth have overlapping and tight spaces between them, there will be difficulty in reaching all of the tooth surfaces with brushing and flossing. That leaves food behind in those nooks and crannies, and adds to the growth of bacteria and for starters, bad breath.

Self Esteem

A bad bite or bad smile can cause self-esteem issues, and can affect a person’s attitude and overall happiness. This is one of the biggest reasons why people visit our office.

Overall Health Issues

If you have been reading our blogs or paying attention to the news, you know that dental health affects overall health. Studies have proven that oral infections and bad bacteria can lead to heart disease, stroke, diabetes, and other ailments. Inability to properly chew food can also affect nutritional health.

Crowded Teeth Treatment

So, what can be done to fix teeth crowding? Treatments range from minor intervention with a removable appliance, to possibly needing months or years of treatment, or in extreme cases, removal of one or more teeth. The best treatment needed to fix your teeth crowding problem depends on how severe your crowding is and your age when starting treatment. Relief of dental crowding does not necessarily require extraction of teeth, and dentists goal is to treat the vast majority of cases on a non-extraction basis through using various other space creating strategies. Possible courses of treatment include:



The most common orthodontic technique to fix teeth that are crooked or overcrowded is to use braces. These include:

  • Traditional metal braces with brackets attached with wires
  • Brace systems using clearceramic brackets attached with wires
  • Adjustable braces, which may have metal or ceramic brackets but don’t have individual wires attached to each bracket
  • Lingual braces that are attached to the inner surface of the teeth so they are less visible
  • Invisalign, a series of removable clear plastic aligners.

All of these systems require at least one year of treatment, and you must wear a retainer for at least a year (and often longer) after the braces come off. They require meticulous attention to oral hygiene and some dietary restrictions (neither of these is an issue with Invisalign since the aligners are removable). Nevertheless, it is possible to fix overcrowding teeth braces or to fix overcrowding teeth Invisalign.



When teeth are crooked due to minor overcrowding or are crowded even though straight (this is not common as crowding nearly always results in crooked teeth), a retainer may be a good solution. A retainer provides the necessary pressure to move crowded teeth, but it not designed (as braces are) to straighten individual teeth. However, resolving the problem of crowding may also have the effect of straightening some teeth. Retainers come in two styles:

  • Fixed retainers are attached to the surface of the teeth with a dental cement. Bonded lingual retainers are attached to the inside (tongue side) of the teeth to push the teeth outward and create enough room to resolve overcrowding. They can be used in the upper or lower jaw.
  • Hawley retainers are made from a dental impression of the teeth. These removable retainers are fashioned from acrylic and wire formed to the shape of the mouth. They can be made for the upper or lower teeth.

Both types of retainers work well to make more room for the crowded teeth. Removable retainers make it easier to clean the teeth and allow you to remove them when you eat or you feel very uncomfortable. However, especially in younger patients, removable retainers are easily lost once they are taken out. The fixed retainer solves that problem but requires meticulous attention to the oral hygiene.

Is your jaw the problem?

Sometimes teeth are crowded because of the jaw – it may be out of alignment, causing bite problems that make the teeth move, or because the jaw is too small for the number or size of the teeth. These problems require different correction strategies. The Herbst appliance, headgear and palatal expander are the primary treatments for these cases.

  • The Herbst appliance is made of metal and consists of attachments to the molars of the upper and lower jaw and a metal extension tube that can be adjusted to put pressure on the jaw. Adjusting the extension tube gradually moves the lower jaw forward, which corrects malocclusion that may be causing crowded or crooked teeth.
  • The headgear is used to correct the upper jaw when a child has a significant overbite. The headgear itself is removable, but it also requires brackets on the rear molars to which the headgear is attached. Patients must wear the headgear for 12 to 16 hours a day.
  • Palatal expanders are used to widen the upper arch of the teeth. As the arch widens, it allows more room for teeth so they can gradually move into their correct positions. The appliance is attached to the upper molars with a dental cement. The expander has a screw in the center that can be adjusted with a special key, placing gradual pressure on the sides of the jaw. As the space increases, extra bone grows between the two halves, which widens the mouth.

Each of these appliances has advantages and disadvantages. The headgear is removable, but that can make it tempting to take it off when it is uncomfortable or not wear it long enough each day. Although it can be worn at night, it may be uncomfortable to sleep in. Herbst appliances and palatal expanders are visible to others. All of these devices require extra care in performing oral hygiene.