Crowding: too little space for too many teeth
The most common malocclusion of all – and the one with the most treatment options.
Crowding means: the dental arch is shorter than the combined width of the teeth that have to fit into it. The result is crooked, rotated or overlapping teeth, usually in the area of the lower incisors or the upper canines.
Where the lack of space comes from
Tooth size and jaw size are inherited independently of each other – large teeth in a narrow jaw are therefore not uncommon. Added to this is an acquired cause: if a primary tooth is lost too early, the neighboring teeth drift into the gap. The permanent tooth then finds no space left and erupts out of line or remains stuck.
What follows from it
Overlapping teeth are harder to clean. Plaque settles exactly there, where neither brush nor floss reaches it reliably – the risk of tooth decay and gum inflammation rises. Mild crowding of the lower incisors without such consequences, on the other hand, is widespread and not a compelling reason for treatment.
Three ways to create space
Widen the jaw while it is still growing. Grind the teeth minimally narrower at their contact surfaces – a procedure that allows only a few tenths of a millimeter per tooth. Or remove teeth, usually the premolars. Which way is an option depends on how much space is needed: a few millimeters can be solved differently than a deficit of a centimeter.
The essentials at a glance
- Crowding means: the dental arch is shorter than the combined width of the teeth. It is the most common malocclusion.
- Tooth size and jaw size are inherited separately. A primary tooth lost too early makes the lack of space even worse.
- Overlapping teeth are harder to clean – the risk of tooth decay and inflammation rises there.
- Space can be created in three ways: widening the jaw, grinding teeth minimally narrower, or removing teeth.
Answered briefly
Frequently asked questions
No, and it is not the first choice either. With a few millimetres of space shortage, widening or slight polishing of the contact surfaces is enough. Only with a larger deficit does the removal of teeth come into consideration – usually the first premolars.
Late crowding of the lower front teeth is widespread and also occurs without previous treatment, often between the ages of 20 and 40. After orthodontic treatment, a retainer is the only reliable protection against it.
The targeted slimming of the contact surfaces between the teeth, technically known as interproximal enamel reduction. Only a few tenths of a millimetre per surface are permitted; the enamel remains intact. Carried out correctly, the procedure does not increase the risk of caries.
Not directly, but it favours it. Where teeth overlap, plaque remains that the brush cannot reach. Whether that turns into caries is decided by oral care – it is simply more difficult in such places.