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Orthodontics/Do I need braces?


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So I'm in grade 7 and recently one of my friends said that I should consider getting braces and this has got me feeling pretty concious about my teeth. I know that my teeth aren't perfect but I personally don't think they are THAT crooked either. I have an overbite and its not the actual teeth that are sticking out, it's the gum itself. There's a small gap between the two front teeth that my dentist said will so disappear. My two front teeth are slightly larger that my other teeth. My bottom row and the rest of my upper row of teeth is also considerably straight. I have attached a photo as well. I have been wearing plates for 4 years now and it has certainly helped- my overbite used to he SO much worse! Do I still need braces? BTW, I don't actually want braces. Is there any other alternative?

Dear Kayla,

I just received your question yesterday, pardon the delay. Also, thank you for including a photo. I just want readers here to know that when a person asks a question, and there is no photo supplied, then it makes it very difficult to diagnose and provide possible options for them to consider when they in turn again consult with their dentist or orthodontist.

As always, the information here is not intended as a definitive diagnosis, A consultation with your oral health professional, along with the proper diagnostic records will help allow a proper diagnosis and treatment plan to be developed. Having said that, you asked for my observations on the following basic question:  

 Do I still need braces? BTW, I don't actually want braces. Is there any other alternative?  

The question of whether orthodontic treatment is needed, whether via braces, clear aligners such as Invisalign, or some other modality, is often based on two factors namely function and esthetics.

In looking at your image, the space between your upper two front incisors may or may not be an esthetic concern. If it bothers you, it is, if not, then perhaps it is not. Functionally, there may be a concern for food impaction. That is, food debris may become lodges in between your teeth.

Some patients with this sort of a condition, often called a “ diastema” by dentists, experience an impact on their speech, specifically the “ SSS “ sounds in the English language. By using their tongue, many patients can compensate for this gap  and overcome this speech deficit.

In terms of treatment options, I am not able to fully determine whether this gap is your only problem. Assuming the bite and the alignment of all the other teeth are fine, then closure of this anterior upper “diastema”  should be fairly simple. Placing a limited series of brackets on the upper teeth for a short while is one option. You asked for "alternatives".

A second option would be to use a series of clear aligners. The very popular “Invisalign” brand of aligners would be one option. It does seem however that your problem is so slight that just two or three aligners custom made by a local dental laboratory might be much more affordable. Ask your dentist, orthodontist, dental health therapist, or other oral health care professional, about these options. I would also ask about what retainers would be best to help keep the gap closed once treatment is completed. There are both fixed (bonded) as well as removable retainers.

Finally, I cannot discern what your bite is like, and it is important to determine whether the upper and lower front incisors will properly " contact " on another once the space is closed.   Sometimes in cases like yours the upper and lower front incisor teeth already contact fairly hard, and this sometimes, along with forward pressure from the tongue, has led to the gap being there in the first place. If the teeth in fact already do hit quite dramatically with the gap there, then space closure, while possible, may involve not so much closure of the gap and rearward retraction, but upper gap closure of the two central incisors and possible supplemental esthetic bonding of the upper left and right lateral incisors .   Please feel free to resubmit your question with a follow up and additional images if this is the case and you have some more concerns.

In my informal opinion, I would say go ahead and have the space closure done. In the future, issues like job interviews, social interactions, and other scenarios may have you appreciating the fact that you did make the commitment to gt the space closed.

Thank you for your question Kayla.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist  


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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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