Addressing Misaligned Molars After Orthodontic Treatment in Teens

Q: Addressing Misaligned Molars After Orthodontic Treatment in Teens

Hello Magi： It is recommended to take a panoramic X-ray to examine the positional relationship between the second molar and the third molar. <br>If it is indeed an issue caused by the wisdom tooth pushing against it, then extraction of the wisdom tooth would suffice. <br>As for t

The upper second molar erupted tilted after orthodontic treatment?

Hello Dr.
Chiu,
My child is 15 years old and is nearing the completion of orthodontic treatment.
During a dental cleaning last year, the dentist discovered that both upper second molars are tilted (growing towards the cheek).
We quickly returned to the orthodontist for an examination.
The orthodontist placed small screws on the upper and lower second molars and used rubber bands to try to correct the tilt of the upper second molars.
One of the molars has indeed been somewhat corrected over the past year.
However, during a recent follow-up appointment, we found that both second molars are still tilted.
The orthodontist then used a different method to try to correct these molars (I had many questions, but I felt he answered them with little confidence, and honestly, I didn’t fully understand his explanations; I was just hurriedly told to return in six weeks!).
I would like to ask Dr.
Chiu: Is the tilting of the newly erupted upper second molars after orthodontic treatment due to insufficient space? Since my child is in puberty, I am concerned that the eruption of the wisdom teeth will further exacerbate the tilting of these second molars.
If it is indeed a space issue, the orthodontist told me that it is not possible to create more space through extractions (as my child has already undergone two phases of orthodontic treatment).
Is this true? I understand that molars play a crucial role in chewing function and should not be extracted.
With six weeks to go, I am quite anxious.
Having come this far, I really don’t know what to do.
I sincerely hope Dr.
Chiu can provide some guidance; I would be immensely grateful for your insights!
A worried mother

Magi, 40~49 year old female. Ask Date: 2005/04/11

Dr. Qiu Qiongyao reply Dentistry

Hello Magi: It is recommended to take a panoramic X-ray to examine the positional relationship between the second molar and the third molar.
If it is indeed an issue caused by the wisdom tooth pushing against it, then extraction of the wisdom tooth would suffice.
As for the buccal inclination of the second molar, the orthodontist has methods to correct it.
However, this will require time, so please continue to monitor the situation.
If it does not improve, then it may be necessary to explore other orthodontic approaches.

Reply Date: 2005/04/11

More Info

Dear Concerned Mother,
Thank you for reaching out with your concerns regarding your child's orthodontic treatment and the misalignment of their molars. It’s understandable to feel anxious, especially when it comes to your child's dental health and the potential implications of their developing teeth.

Firstly, it is not uncommon for molars, particularly the second molars, to exhibit some degree of misalignment during or after orthodontic treatment. This can be attributed to several factors, including the natural growth patterns of the jaw, the timing of tooth eruption, and the available space in the dental arch. In your child's case, the orthodontist's use of temporary anchorage devices (TADs) and elastic bands is a common approach to correct the positioning of teeth that are not aligning properly. The goal is to guide the teeth into their proper positions gradually.

Regarding your concern about whether the misalignment is due to insufficient space, it is indeed a possibility. As children grow, their jaws undergo significant changes, and sometimes the available space may not accommodate all the teeth properly, especially if there are late eruptions of teeth like the second molars or wisdom teeth. If the orthodontist has indicated that there is no possibility of creating more space through extraction, it may be due to the fact that your child has already undergone two phases of orthodontic treatment, which often aims to preserve as many teeth as possible for functional and aesthetic reasons.

You mentioned the concern about the eruption of wisdom teeth exacerbating the misalignment of the second molars. This is a valid concern, as wisdom teeth can sometimes push adjacent teeth forward, leading to further crowding or misalignment. However, the timing of wisdom teeth eruption varies widely among individuals, and not all patients will experience significant issues. Regular monitoring by the orthodontist or a dentist can help manage this situation effectively.

As for the current treatment plan, it is essential to maintain open communication with the orthodontist. If you feel uncertain about the explanations provided or the proposed treatment, do not hesitate to ask for clarification. It is important that you and your child understand the rationale behind the treatment methods being employed. You might also consider seeking a second opinion from another orthodontist if you continue to feel uneasy.

In the meantime, encourage your child to maintain good oral hygiene, especially around the areas where adjustments are being made. Proper brushing and flossing can help prevent any complications that might arise during this period of adjustment.

Lastly, it’s important to remain patient during this process. Orthodontic treatment can take time, and while it may feel frustrating now, the adjustments being made are aimed at achieving the best possible outcome for your child's dental health. After the six-week period, you will have a clearer picture of how effective the current treatment has been and what the next steps will be.

I hope this information alleviates some of your concerns. Remember, your child's dental health is a journey, and with the right care and guidance, they will achieve a healthy and functional smile.

Best wishes for you and your child’s orthodontic journey!
Sincerely,
Doctor Q&A Teams

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