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Braces

Tooth Becoming More Crooked

10/26/2010

Question:

My daughter has had braces for a year and four months, and her teeth are pretty much all straight, except for her top front left one(central incisor). This tooth is slightly pushed up and back and was pushed back even more with the last visit four weeks ago. I am unsure if this is the tooth itself as she had a 3 way removable expander from general dentist that didn`t work (no retention) then palatal expander that did NOT make any space between teeth after 20 turns before braces this time. The braces are still scheduled were scheduled to come off in December but the tooth has become more pushed back each visit. I took her in for a check because the teeth were sensitive and the ortho states that she had a light wire put on due to her second molars being bracketed at the last appointment. Should this be making her front tooth significantly more crooked that before braces? Could the multiple (removable and fixed expansion) somehow have damaged the roots or periodontal ligament? Is there any way to get this checked? Her orthodontist has made several mistakes on friends and does not try to correct during the treatment--he just tells everyone this is a risk of treatement after its over and the damage is done. Since the tooth has become worse, should I be worried or do teeth become significantly worse toward the end of treatment before fine tuning is done (per the orthodontist)? Also, he has now backed up the date for the braces to come off to indefinitely even though this is the only crooked tooth right now. Is it normal for this tooth to be getting pushed more into the gum and back at this late stage in the treatment? The other orthodontist in this area just states the teeth take time to become straight and I need to finish treatment with this ortho so I don`t think another ortho will give me a second opinion.

Answer:

Well I too would be concerned. However if the orthodontist stepped back to a lighter wire to correct second molar placement, this could be the problem in that the wire in the front is not strong enough to hold the anterior tooth in position. As he returns to a heavier wire this should correct the problem. 

Do not push the finish date because the tooth needs to be held in correct position for a while. Also when it comes time for retainers make sure your daughter complies well.

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Response by:

Walter C Buchsieb, DDS, MS Walter C Buchsieb, DDS, MS
Professor Emeritus - Clinical, Associate of Dentistry
College of Dentistry
The Ohio State University