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Whoever said that it’s supposed to get worse before it gets better must have had braces in mind. And if you’re wearing braces right now, reading this article, this probably applies to you. So before you start worrying that your orthodontist isn’t doing a great job, grab your favorite beverage and keep reading.
Braces will shift teeth in whatever direction the archwire dictates. The process of correcting your bite can make your teeth look worse instead of better. This is called decompensation, and we often see it in our patients. Decompensation is a temporary but necessary stage of orthodontic treatment.
While some patients enjoy the magic of seeing their teeth straighten with each passing day, others experience the “messy middle”, with their teeth becoming worse before their orthodontist corrects them and finalizes treatment. So why does this happen? And can braces actually harm your teeth? Find out in this article.
Why are your teeth looking worse during treatment?
Before getting braces, your teeth were in relative balance, despite being crooked and your bite being off. Your teeth leaned in different directions so they could come in tight contact with each other. This is called compensation.
Braces disturb that fragile compensation, and it may seem to you like things are getting worse instead of better. I won’t go too much into technicalities, but instead, I’ll guide you through the most common complaints that patients have during orthodontic treatment.
To better understand this, you’ll need to know about the main stages of braces:
- Working phase
Depending on which stage you’re in, you’re going to encounter different types of issues. Hopefully, I’ve answered your questions below.
Are your braces making your teeth more crooked?
During the alignment stage, we’re straightening teeth in preparation for bigger wires. We align teeth using soft, bendable wires that apply gentle pressure, moving teeth like beads on a string.
If you have small jaws and crooked teeth, aligning them won’t be as easy or straightforward. Sometimes, we choose to only straighten certain teeth, leaving others behind until we make more room.
It can seem like the tooth that’s left behind is becoming more crooked, because the other ones are so straight now. Or that tooth is indeed being pushed back towards the tongue, or forward, but I assure you it’s an easy thing to correct.
If you’re unsure about why your teeth seem more crooked, just ask your orthodontist. Correcting teeth in succession is very common, and you may not have all your teeth engaged in the wire at first.
Are your braces making your bite uneven?
During the leveling phase, we’re working on achieving level, parallel arches that fit well together. For many (if not most) patients, this isn’t easily achieved. There’s a lot of work that involves wearing rubber bands, extracting teeth, or even orthognathic surgery.
If your bite starts to become uneven during orthodontic treatment, it’s because your teeth are nice and straight now, but the arches aren’t coordinated.
Your teeth can even seem slanted, and this is also a result of teeth that are straight but not corrected within the bigger picture of your jaws and bite.
This is where the hard work begins, and your orthodontist will work on getting your bite stable before your braces come off.
Are your braces causing gaps?
Another thing that you may notice is new gaps forming between your teeth while wearing braces. I dedicated an entire article on this topic, but let me summarise it for you:
If you have narrow dental arches, braces will widen them, and you may temporarily get some gaps, especially between your front teeth. Consider these gaps a good thing, they’re a sign that you’ll get the wide beautiful smile you want.
If it takes a while to close these gaps or any extraction gaps you might have, don’t worry. Your orthodontist may choose to close these spaces later, on a thicker archwire.
While the rate of space closure averages 1mm/month, I found that it entirely depends on the patient’s biology. So if your teeth are moving slowly, try to be patient. I know, easier said than done.
Can your teeth look worse after taking braces off?
If you just got your braces removed and your smile seems off, but you can’t quite put your finger on it, it’s possible that your teeth are too flared and just don’t look natural.
Braces can cause flared teeth if your orthodontist didn’t extract teeth and tried to solve your crooked teeth by simply aligning them. Many patients refuse to get extractions, so their doctor should explain that flared teeth are a real possibility.
Other orthodontists don’t like extracting, so they try to widen the arches, shave off the teeth, have the patient wear rubber bands, and do all kinds of tricks to reduce the flaring. But it doesn’t always work.
So what can you do to correct flared teeth? If your braces are off, there’s not much you can do except get back into orthodontic treatment. If you still have braces on, you can seek another opinion and probably extract 2 to 4 premolars. This will add 12 to 18 more months to your treatment, but at least you’ll correct that bothersome flaring.
Can braces damage your teeth?
We’ve addressed the position of your teeth so far, but what if what’s bothering you is the state of your gums and teeth while wearing braces?
Can braces actually damage your teeth or worsen your overall oral health? Well, yes and no. While braces in themselves are passive, they do contribute to plaque accumulation, which can wreak havoc in your mouth.
Your gums can swell, become red and puffy and even grow on top of your braces, bleeding at the slightest touch. This type of severe gingivitis can put an end to your orthodontic treatment, as many doctors decide to debond braces so that the gums can recover. Read more about it in this article.
With any plaque buildup, you can expect dental cavities, particularly white spot lesions. White spot lesions are chalky cavities on your enamel outlining a bracket that only become obvious after taking braces off. While these lesions stop advancing once you have your oral hygiene under control, they often permanently mark teeth and look unattractive.
Taking braces off can also scratch your enamel slightly, although most orthodontists are skilled enough to keep these scratches to a minimum and polish the enamel thoroughly.
And lastly, braces can cause your gums to retract on certain teeth. This happens because your gums are really thin and the tooth doesn’t have enough bone to support it in its new position.
These are all risks you must acknowledge when getting braces on. No method of straightening teeth is perfect, and having perfect oral hygiene is what makes most of these problems preventable and reversible.
Hopefully, you’re seeing your smile get better with each day, but if that’s not you, don’t panic. Voice any concerns you might have, most orthodontists are more than willing to explain the entire process. Since your treatment will probably take a while, it’s important that you’re at ease and understand exactly what’s going on with your teeth and bite.
Whether you’re new to braces or a braces veteran, taking care of your teeth (and your health) during orthodontic treatment is crucial. That’s why I’ve put together a list of orthodontist-recommended tools that will make caring for your braces a breeze: