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Orthodontics/Sloping teeth


Hello, I've had braces when I was a teenager for a few years (I'm now 30). As you can see from the image, my upper teeth slope quite a bit on one side. It makes me self-conscious and I don't really smile on photos and if I do, only when I'm sideways so the slope is not visible unlike when it's a frontal shot.

My question is, can this be repaired with braces (or some other method?) or am I stuck with this?

Thank you for your time.


Hello Dana,

I sometimes have to apologize for delayed responses to questions from readers, and this is one of those occasions. In any case, you wrote about what seem to be some slight aesthetic concerns dealing with “sloped teeth”.  

I am thankful for your picture, as it does show a lot of things.
Again, what I write here are only my opinions based on limited information. No X-rays or study model images were included. Any comments should not be viewed as any form of diagnosis, definitive or otherwise, or any form of treatment recommendation.  As you know Dana, 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.

Now in the image you sent one can see several things.

There is a slightly deep anterior vertical overbite.

The upper two central incisors slightly overlap one another, and are not quite ideally aligned vertically, or symmetrically at a slight inclination which could also be acceptable.

One of your right posterior teeth, what appears to be a premolar, shows an edge to edge or crossbite  relationship

Your left posterior also seem to be in a posterior crossbite relationship.

** A posterior crossbite is a relationship where instead of the upper teeth overlapping  and covering the lower teeth like shingles on a roof, but the opposite. If you look at the image, your left posterior teeth (on the right side when looking at your picture)  do not mesh normally either.  

Now I mentioned all these because your chief concern was the following:

“ my upper teeth slope quite a bit on one side  “  

Well, now the question, what to consider doing. Again, do check with your Dentist or Orthodontist before engaging in any treatment.

The crossbites, if they are indeed present, are difficult to treat in an adult.  Crossbites can be due to poorly angulated teeth ( a dental crossbite ), relatively narrower upper vs lower jaw width (skeletal crossbite), or a combination of dental and skeletal factors.  I will not comment on addressing crossbite correction in adults in this response. It warrants an entirely different and much longer reply which may include surgical orthognathic  procedures. Moreover, it also would require diagnostic radiographs to even begin to discuss with any reasonableness.

Regarding the slightly deep anterior vertical overbite, I would say that your condition is not that profound. Deep anterior vertical overbites can often be treated, both in adults and adolescents, by using a removable bite plate appliance that relies on passive eruption of the posterior teeth to correct the deep bite Correction in young children who do not yet have a sufficient number of adult teeth is not usually recommended. The deep bite correction via passive eruption requites sufficient numbers of posterior adult teeth, namely the adult premolars and molars.

Finally to your specific question regarding the “sloping” of the central incisors. By sloping I am interpreting this as the manner in which the teeth, when you look at yourself directly head on in the mirror, are more or less not quite vertical, but slant a little sideways.

For this I see two solutions Dana. Consider putting braces on your teeth for a matter of just a few weeks, perhaps 4-8 weeks with maybe one or two adjustment appointments.  The second option is to have your doctor provide you with a series of several clear aligners. There are many brands in the US such as Invisalign , Clear Correct, etc.  In the US, many private dental labs such as Specialty Appliances in Georgia and North Star in Minnesota also provide such services.  Each approach will likely work, and I am not familiar with what dental laboratories are available in the Czech Republic.  Your good neighbors just across the border in Austria and Germany certainly have many dental labs that can provide clear aligners as well.

So that basically is a summary of some of your “problems’ as revealed in the image. I also have offered some possible solutions for you to take to your doctor so that he/she can help diagnose and treat your aesthetic concern.  After you have the anterior upper teeth all properly aligned, you can also consider other aesthetic enhancements such as tooth whitening.  

I would also pay close attention to the gum contouring and your periodontal health. Puffy gum tissue and poor gingival roll  of the gum tissue over the tooth can also affect aesthetics.  The tooth can sometimes be excessively covered by inflamed gum tissue, making the tooth appear short and undersized.  

Also, there is the question of whether this slow “shifting and relapse” which may be continuing. If you do get this corrected, ask the doctor about wearing a retainer long term . These are just some things to think about s you and your doctor discuss achieving that perfect smile.

Co můžeš udělat dnes, neodkládej na zítřek.
Don't put off till tomorrow what you can do today.

I hope my comments have been helpful. As you know Dana,  the website here encourages readers like you to rate the answers and to resubmit with follow up questions. Good luck with your retainers, and thank you for writing.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health

Please allow a full week for a reply; my replies are generally fairly extensive and researched. 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. I sometimes consult with other doctors on complex interdisciplinary questions. This of course takes time.  Your understanding is appreciated.  


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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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