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Orthodontics/Braces in the future


I've had quite a bit of dental problems. Some of which still isn't fixed. But the worst of it is dealt with. However I'm concerned because of how it was fixed, I may not be able to fix my biggest insecurity about my teeth, and that's one very crooked tooth. It's at the very front and pushed back rather far. A few other teeth are cooked but not so badly. I've always thought I'd need braces to fix it, but three of my teeth had to be filled and pretty much rebuilt. They're not caps. Would the filling those teeth are made up of be able to support braces? Or will it keep me from getting them?

Hi Roberta,

What I write here are only my opinions based on very limited information. My comments should not be viewed as a definitive diagnosis or any form of  treatment recommendation.  Indeed, in the ultimate analysis all final decisions, particularly clinical ones, should  only be made by qualified doctors who have had a chance to see you in person and who have had an opportunity to take and analyze proper diagnostic records.

Okay… having said  that…  your  questions focused on whether 4extensively restored anterior teeth are able to sustain  orthodontic treatment..  You  wrote:

I'd need braces to fix it, but three of my teeth had to be filled and pretty much rebuilt. They're not caps. Would the filling those teeth are made up of be able to support braces? Or will it keep me from getting them?

My biggest challenge in answering questions lime this is that I do not have any xrays, photos, or study models to examine. Based in what you have said I would say that your orthodontic treatment needs are perhaps. Also, please consider an option of having only limited orthodontics done, that is treatment which may not treat ALL your issues, but would address your main concerns. In this case, that would be the aesthetics of your anterior upper incisors.

Regarding the restorations, you have justifiable grounds for concern. Brackets can be placed on such teeth, but with great caution. if the crowding is not that severe, another method which might correct the issue is to use clear aligner appliances. Currently companies including Clear Correct, NorthStar, Invisalign and others offer clear aligners which  may be able to correct the front teeth.

Another concern  have is that once the teeth are correctly positioned, the restorations which you did have may now look awkward or uneven. Your dentist may have tried to compensate for the damage and mis-alignments by cosmetically sculpting the shapes of the teeth in such a way as to give you the best appearance possible. Once orthodontics is undertaken, the basic landscape changes and everything may appear very  different.

Roberta, here are steps for you to consider:
1) Check with your dental professional who will be doing the orthodontics whether limited treatment of just the incisors is possible
2) Ask if braces can be used, and if so what advantages/disadvantages there may be vs using a a clear aligner approach such as Invisalign.
3) Ask whether clear aligners can be used and what the cost, safety, comfort, etc comparison is between the two approaches.

Roberta, if you have any questions please writer again, but if possible include photos . All the best.


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Paul Supan, DDS, MA, MPH


First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites and are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.


Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Available upon Request.

BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

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Available upon Request Please see my personal websites and for further personal background.

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