Common Orthodontic Issues

People often wonder, “What does an orthodontist do?” While the most common understanding is that we simply fix crooked teeth, there is actually much more to orthodontics than meets the eye. Malocclusion like crooked teeth is indeed something that orthodontists are trained to fix with Invisalign® or different types of braces. However, many other pressing issues can be addressed with orthodontic work. Below you can learn more about these issues as well as some of the achievements we have made at our Oregon City dentist’s office.

Crowding of the Teeth

When permanent teeth come in too close together, they tend to “crowd” one another. When one tooth occupies another tooth’s space, one or both will likely develop at an improper angle. This leads to crooked teeth and an unsightly smile. Tooth crowding is an extremely common issue that is usually based purely on genetics. Fortunately, options like clear aligners and adolescent or adult braces can remedy this situation - even with severely crowded teeth. The patient began orthodontic treatment at age 11 and wore braces for 26 months. He loves his new smile.

crowding of the teeth beforeBefore
crowding of the teeth afterAfter

Open Bite - Front Teeth Don't Touch

open bite beforeBefore
open bite afterAfter

Sometimes the front teeth of the upper and lower rows do not make contact when a patient’s mouth is at rest. This is known as an open bite since the teeth leave a gap, or opening, at all times. This is common among young patients who frequently suck their thumbs. However, it can also be caused by thrusting the tongue against the back of the teeth. This patient sucked her thumb as a young child. She started her orthodontic treatment at age 13. She had braces and a special appliance, called a crib, to retrain the tongue, for 28 months. Now she can bite the lettuce out of a sandwich.

Deep Overbite - Lower Front Teeth Bite Into Palate

deep overbite beforeBefore
deep overbite afterAfter

An overbite occurs when a patient’s upper row of teeth extends beyond the bottom row. A deep overbite describes a more severe overbite. This can happen when the lower jaw is smaller in comparison to the upper jaw. Luckily, this issue can be overcome with traditional metal braces or Invisalign aligners. These treatment options can help correct the alignment of the upper and lower jaws.

This adult patient, age 25, required braces and jaw surgery to correct his severe overbite, with the entire treatment taking two years. His problem could have been corrected without surgery if he had been treated before he was a teenager.

Missing Lateral Incisors

missing lateral incisors beforeBefore
missing lateral incisors afterAfter

Lateral incisors are the teeth that directly neighbor the two front upper teeth. This is often due to anodontia, a condition where one or more temporary or permanent teeth are missing due to genetics or heredity.  A pediatric orthodontist can remedy this situation by using braces to correctly position the other teeth before replacing the incisors with dental bridges.

This patient's lateral incisors were congenitally missing. She had braces for 20 months to move the teeth into their correct positions, then the missing teeth were replaced with bonded "Maryland" bridges.

Underbite - Lower Front Teeth in Front of Upper Teeth

underbite beforeBefore
underbite afterAfter

An underbite occurs when a patient’s lower row of teeth extends beyond the upper row. There are varying levels of underbite; some may be highly visible while others are difficult to detect. In any event, this form of malocclusion can excessively wear down teeth or cause discomfort to the patient. Specifically, it can cause joint pain in the jaw as the patient’s rows of teeth are not resting upon one another properly. This can be corrected during childhood with pediatric orthodontics or in adulthood with adult braces.

This patient's underbite was causing her jaw joint discomfort and excessive wear patterns on her teeth. After about 30 months of treatment starting at age 32, she now finds smiling and chewing much easier.

Spacing of Teeth

spacing of teeth beforeBefore
spacing of teeth afterAfter

Just as teeth can come in overly crowded, they can also develop too far apart. This creates gaps in the teeth. This condition, known as diastema, can occur when the jaw is too large for the teeth and is often hereditary. While some patients simply do not like the way the gaps look, diastema may be the result of certain dental issues or the cause of others. Fortunately, options like braces and Invisalign can help eliminate these gaps.

This patient was bothered by the spaces between his teeth. Braces closed the spaces and gave him an ideal bite in 24 months. Special glued-in retainers help keep the spaces closed.

Overjet - Protruding Front Teeth

overjet beforeBefore
overjet afterAfter

Overjet occurs when the upper teeth “stick out” over the lower teeth. It is not to be confused with an overbite, which simply refers to the alignment of the upper and lower rows of teeth. Overjet teeth are sometimes referred to as “buck teeth.” Overjet can cause difficulty with biting, chewing or drinking, but it is also easily remedied by orthodontic treatment like braces.

At age ten, this patient had a big overjet with the top teeth protruding beyond the bottom. She had two phases of treatment: The first helped her jaw to grow more harmoniously and, the second, aligned her teeth and bite. At age 13, she was proudly displaying her new smile.

Non-Braces Treatment

non braces treatment beforeBefore
non braces treatment afterAfter

Sometimes traditional metal braces are not needed to solve issues with tooth alignment or spacing. For example, pediatric orthodontists can make small adjustments with children’s teeth as they are coming in to avoid braces in the future. Invisalign aligners are another alternative to braces, especially for adults who may feel self-conscious about wearing them.

This patient was first seen at age seven for crowding of the lower permanent teeth. An orthodontic procedure was performed to reduce the width of the adjacent baby teeth and the permanent incisors aligned on their own in nine months.


phase 1 beforeBefore
phase 1 afterAfter

Phase-one treatment, sometimes known as interceptive orthodontics, can be administered before all of a child’s permanent teeth have grown in. It is largely a preventative measure that can help the rest of the teeth grow in properly to reduce the amount of orthodontic work required in the future or, in some cases, avoid it altogether.

This patient's parents were concerned about both aesthetics and the health of the erupting permanent teeth when they brought him to the orthodontist at age eight. The lower front teeth were crowded and touching the palate, and the upper front teeth were extremely displaced from their normal positions. After 12 months of Phase-One treatment with an expander and partial braces, the patient's appearance and dental function was vastly improved.

If you would like to learn more about solving any of these issues for yourself or a loved one, or you would like to request an appointment, contact Noel Orthodontics today! Dr. Noel is an Oregon City orthodontist serving patients of all ages and providing them with beautiful smiles.

Additional Information:

Office location

911 Main St #160
Oregon City, OR 97045
(503) 655-5125

Office Hours

Mon & Tue: 8a-5p
Wed: 7a-4p
Thu: 7a-3p