Orthodontics vs. Aesthetic Dentistry: Which Comes First?

Q: Orthodontics vs. Aesthetic Dentistry: Which Comes First?

Hello： 1. <br>It is recommended to consult with an orthodontist first. <br>During the orthodontic treatment, a temporary restoration can be used to restore the shape of the damaged teeth to a certain extent. <br>After the orthodontic treatment is completed, you can consider wheth

Sequence of Orthodontics and Dental Restoration, Tooth Sculpting

Hello, Doctor.
I have two questions I would like to ask:
1.
I have several teeth (about 5-7) that previously had resin fillings, which have now discolored.
Additionally, traditional fillings do not restore the original shape of the teeth, so I am considering using biomimetic restorations (also known as aesthetic fillings) to redo them.
However, I am currently saving money for orthodontic treatment, so I would like to ask the doctor which should be done first: orthodontics or dental restorations? If I get the restorations done first, they will be adjusted to fit my current occlusion, which may lead to misalignment issues later during orthodontics.
Conversely, if I undergo orthodontics first, will the existing poor tooth shapes negatively affect the results of the restorations afterward? (Currently, I do not have any cavities, and I hope that after completing both orthodontics and restorations, my teeth will achieve proper occlusion and look like natural teeth, although I know that might be unlikely xD)
2.
I have a large lower right molar that has undergone 3D dental sculpting.
However, at that time, I was unaware of my occlusion issues, so the dentist adjusted the sculpting to fit my current occlusion, resulting in a flatter shape (with a bulkier cusp).
I would like to know if there will be any occlusion issues after subsequent orthodontics.
If so, will I need to redo the dental sculpting? I realize these questions are quite complex, so thank you in advance, Doctor!

BIBI, 20~29 year old female. Ask Date: 2022/11/03

Dr. Lin Jiayong reply Dentistry

Hello: 1.
It is recommended to consult with an orthodontist first.
During the orthodontic treatment, a temporary restoration can be used to restore the shape of the damaged teeth to a certain extent.
After the orthodontic treatment is completed, you can consider whether there is a need for prosthetic restoration.
2.
If you have already undergone 3D dental sculpting, it will depend on whether it affects the subsequent orthodontic treatment.
If the impact is significant, you may need to ask the orthodontist to remove the dental sculpting and temporarily fill it with a restoration.

Reply Date: 2022/11/03

More Info

When considering the sequence of orthodontics and aesthetic dentistry, it's essential to understand the implications of each treatment on the overall dental health and aesthetics. Your situation involves several factors, including existing dental restorations, the need for orthodontic correction, and the desire for aesthetic improvement.
1. Orthodontics vs. Aesthetic Dentistry: Which Comes First?
In general, the recommended approach is to prioritize orthodontic treatment before proceeding with aesthetic dentistry. The primary reason for this is that orthodontics aims to align the teeth and correct bite issues, which can significantly affect how the teeth fit together. If you were to undergo aesthetic procedures, such as aesthetic fillings or crowns, before correcting the alignment of your teeth, you might end up with restorations that do not fit well once the orthodontic treatment is completed. This could lead to the need for additional adjustments or even replacements of those aesthetic restorations.

If you were to have aesthetic work done first, the restorations would be designed based on your current bite and alignment. Once the orthodontic treatment is completed, the new alignment may render those restorations misaligned or improperly fitting, which could compromise both function and aesthetics. Therefore, it is advisable to consult with an orthodontist who can assess your specific situation and create a treatment plan that aligns with your goals.

In your case, since you have several teeth with resin restorations that have discolored and do not match the original tooth shape, it would be wise to first focus on orthodontic treatment. After achieving the desired alignment and bite, you can then proceed with aesthetic restorations to ensure they complement your newly aligned teeth.

2. Concerns About Existing Dental Work and Future Orthodontics
Regarding your existing 3D dental sculpture on the lower right molar, if it was created based on your current bite, there is a possibility that it may not align properly after orthodontic treatment. If the orthodontic adjustments significantly change the position of your teeth, you may find that the occlusion (bite) is not optimal with the current restoration. In such cases, it may be necessary to redo the dental sculpture to ensure that it fits well with the new bite.

It's important to communicate with both your orthodontist and your aesthetic dentist about your concerns. They can work together to develop a comprehensive treatment plan that addresses both the alignment of your teeth and the aesthetic aspects. This collaborative approach can help ensure that you achieve a functional bite and an aesthetically pleasing smile.

In summary, the sequence of orthodontics followed by aesthetic dentistry is generally the most effective approach to achieving both functional and aesthetic goals. By first correcting the alignment and bite issues, you can ensure that any subsequent aesthetic work will fit properly and enhance your smile. Always consult with your dental professionals to tailor a treatment plan that best suits your individual needs and circumstances.

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