Is Orthodontic Treatment Necessary for Dental Alignment Issues?

Is correction needed?

Hello Dr.
Yang, I would like to ask a question for my friend.
He has a tilted lower right molar that is pressing against his two lower incisors, forming a V-shape, but he does not experience any significant discomfort.
He is concerned that his lower incisors may eventually become parallel and that this could lead to cavities and occlusal issues in the future.
The doctor mentioned that if cavities develop, the molar would need to be extracted, and he might require dental implants or root canal treatment for the premolars.
He was then referred to Dr.
Shen Mao-Gen at Changhua Minsheng Dental Clinic, who suggested orthodontic treatment to correct the molar alignment, which would cost around NT$20,000 and take one to two years.
The doctor also recommended taking a full mouth X-ray (which would cost NT$600 out of pocket) to check for wisdom teeth, which would need to be extracted first if present.

Could you please advise on the necessity and timeliness of the orthodontic treatment? If only the lower arch is corrected, could this lead to more significant issues with the temporomandibular joint in the future? Is the treatment recommended by the doctor the only way to prevent cavities and future occlusal problems? If, after completing the orthodontic treatment, wisdom teeth emerge and cause pressure, would extraction be sufficient?

Guo Xiaojie, 20~29 year old female. Ask Date: 2003/06/08

Dr. Yang Hui reply Dentistry

Dear Ms.
Kuo,
I apologize for not being able to fully understand your situation without seeing your oral condition.
Therefore, I cannot make any definitive statements regarding orthodontics.
As for the pressure caused by the eruption of your wisdom teeth, extraction is the solution.
If your upper and lower occlusion is good, you may only need to undergo orthodontic treatment for the lower arch.
There are many causes for temporomandibular joint (TMJ) issues, and malocclusion is just one of them.
I recommend visiting a dental clinic for an examination.
Sincerely,
Dr.
Yang Hui

Reply Date: 2003/06/08

More Info

Orthodontic treatment is often a necessary step for addressing dental alignment issues, particularly when misalignment can lead to further complications such as tooth decay, gum disease, or jaw problems. In your friend's case, the tilting of the lower right molar is causing pressure on the lower incisors, creating a V-shaped alignment. While he may not currently experience discomfort, the potential for future issues, including cavities and bite problems, makes it prudent to consider orthodontic intervention.

The recommendation from Dr. Shen to perform orthodontic treatment on the molar is based on the principle that correcting alignment can prevent further complications. Misaligned teeth can lead to uneven wear, increased risk of cavities due to difficulty in cleaning, and even temporomandibular joint (TMJ) disorders if the bite is not properly aligned. The cost of $20,000 and the time frame of one to two years for treatment may seem significant, but it is an investment in long-term oral health.

Regarding the timing of orthodontic treatment, it is generally advisable to address alignment issues sooner rather than later. Early intervention can prevent more severe problems down the line, such as the need for more invasive procedures like tooth extractions or root canals. If your friend is concerned about the potential for future dental issues, it would be wise to proceed with the recommended treatment.

As for the concern about developing TMJ issues if only the lower teeth are corrected, it is essential to consider the entire dental structure. Orthodontic treatment aims to achieve a balanced bite, which can help alleviate stress on the jaw joints. If only the lower teeth are treated without addressing the upper teeth, it could lead to an imbalance that might exacerbate TMJ problems. Therefore, a comprehensive approach that considers both the upper and lower teeth is crucial.

If your friend undergoes orthodontic treatment and later discovers that wisdom teeth are emerging, the decision to extract them should be based on their position and potential impact on the alignment achieved through orthodontics. If the wisdom teeth are likely to cause crowding or misalignment, extraction may be necessary to maintain the results of the orthodontic treatment.

In summary, orthodontic treatment is not only about aesthetics; it plays a vital role in maintaining overall dental health. Your friend's situation highlights the importance of addressing alignment issues proactively to prevent future complications. Consulting with an orthodontist who can provide a comprehensive treatment plan tailored to your friend's specific needs is essential. This plan should include considerations for any potential wisdom teeth and their impact on the overall dental structure. By taking these steps, your friend can ensure a healthier and more functional smile for years to come.

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