You’ll see many dental websites talking about the benefits of tooth straightening treatments but what happens if you decide to leave them as they are? Let’s talk about the long term effects of leaving your teeth crooked.
I’m going to say straight away that there are very few incidences where you really should, for your dental health, get straighter teeth. Most of what we do is cosmetic after all, and those patients that really do need to have something done are usually picked up in adolescence. Yes straighter teeth are easier to clean and floss – the gum health is likely to be easier to maintain but with good hygiene even crooked teeth can be kept healthy. You also need to bear in mind that if you do have treatment you need to wear retainers for as long as you wear them to stay straight (yes that does mean forever!)
However, it’s still worth looking at what changes can happen to us over time with regards to our tooth position as this may help you decide if having your teeth straightened is right for you.
The biggest change our bodies go through is growth. Up until our late teens to early twenties facial growth is still continuing and the changes can sometimes be very rapid. Some patients notice that their teeth are straight right up to the point that their wisdom teeth come through, and often blame the wisdom teeth for the loss of alignment in the front teeth. We know that this is actually due to growth changes and not the wisdom teeth, as we still see this happening in patients who never grow their wisdom teeth at all!
Age related changes
As we age, the elasticity of the skin begins to deteriorate leading to wrinkles. The same happens to our teeth – the ligament that holds the teeth into the bone becomes less tight and there is less resistance to the effects of muscle pressure (from lips and tongue). In addition we naturally lose about 1mm per decade of the tooth attachment to the bone (we get long in the tooth!). Any minor irregularity in the position of the teeth tends to worsen over time. Even patients with very straight teeth in their early adult life are prone to progressive tooth movement with age, so it’s entirely possible to have straight teeth that become crooked as you get older.
Another issue we sometimes see in older patients is a lack of gum between the teeth once they are straightened. As a rule a healthy gum will be 1-2mm above the top of the bone around the teeth. In cases where there is a lot of crowding the bone may not grow or may recede between the tight contacts so when the teeth are lined up properly there is no gum and this can lead to dark triangles at the gum level between the teeth. Although this is perfectly ok from a health perspective, for some patients this can be unsightly if it affects the appearance of the front teeth.
Other things can also happen as we age including gum disease, premature tooth loss and tooth wear all which can impact the tooth positions and may raise issues with dental treatment such as crowns and implants.
Adults do struggle with the idea of having braces, and even with Invisalign it’s not all plain sailing. Busy working lives and family responsibility can also mean that they put things on the back burner on the pile of “To-dos” that never quite get done. They can be champion procrastinators! Although age is not a barrier to treatment, it will take a bit longer than a teenager to get straighter teeth, and other dental issues can complicate treatment somewhat. But as long as your teeth and gums are healthy and you aren’t taking medication for osteoporosis you teeth will move no matter how old you are.
Living with crooked teeth can have an impact on our social wellbeing. A patient recently told me that the only reason they went for a new job was that their confidence had been boosted so much from having their teeth straightened, they felt they could go for it. I’m not saying that straight teeth will end unemployment but most patients do report an increase in self-confidence following treatment – even those who come across as pretty confident already.
So does it matter if you don’t straighten your teeth? The answer is of course no. No-one ever died from having crooked teeth, but bear in mind that how you feel now may change in 10-20 years’ time and that may have an impact on what treatment you have or how long it will take.
Is there a right time to have your teeth straightened? – Yes, when you feel ready to take that next step!