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Multiple Failure Causes

Orthodontic issues in dentistry can develop during early stages of physical develop, during later stages (pre-adult) and during adulthood, even after completion of the usual growth spurts that typically occur until we reach 21 years of age, or so.

Growth patterns of the upper and lower jaw structures, eruption process of a normal tooth count and replacement process of supplanting primary teeth with permanent, adult teeth are growth activities that can become disrupted for a seemingly unlimited number of reasons.

Traditional orthodontic treatment is common during early years, administered during key developmental stages that focus on achieving a normal occlusal plane comprised of an upper and lower arch that are well matched in size and width.

Ortho issues involving specific tooth structures (malpositioned, non-erupting, etc) can be treated simultaneously or individually as needed, depending upon the overall orthodontic status of the patient's bite.

Some of the more common problem issues stem from obtaining (or failing to obtain) treatments that are untimely. Adults frequently discover that an orthodontic issue that was deemed non-significant during earlier years can worsen with age... as tooth structures age or "out of occlusion" teeth cause cumulative damage and change to teeth and jawbone relationships.

Conditions of overbite and underbite, for young or older adults are some of the initial signs of treatment need for a changing bite.

Other types of orthodontic changes accruing to trauma, active disease process, excesssive loss of teeth (unwarranted extractions, excessive caries) are also frequent among adult populations.

This gallery contains examples of orthodontic issues that are caused by some of the more unusual or uncommon causes of occlusal or alignment issues that can accrue.





An unusual example of an adult orthodontic issue that is compounded by active periodontitis. Disturbances in the occlusal plane are quite obvious. Significant differences in the quantity of underlying bone tissue are also evident.

Treatment recommendations would include effective treatment and arrest of active disease process, fortification of bone tissue and gingiva (via grafting) as needed and replacement of treatment of certain tooth structures, as needed, through combinations of implants, crowns, dentures or partials, or fixed prostheses.

Bad Orthodontics Periodontitis Combination
Periodontitis - Adult Orthodontic Issues
Richard Winter, DDS, MAGD


An example of what can happen with adult teeth that were treated by an orthodontist but recommended permanent use of night time retainers was not followed by the patient. A more complex version of the "shifting teeth" phenomenon that occurs with adult patients who had successful orthodontic treatments during the formative years but eventually stop using retainers or retainers become lost, broken, damaged.

Treatment recommendations could include retreatment with traditional orthodontics, use of Invisalign Clear Braces, custom veneer products, implants, crowns, bridgework, dentures, partials.

No Retainer Shifting Orthodontic Failure
Shifting Teeth - No Retainers
Mitchell Pohl, DDS


Genetic - developmental orthodontic and occlusal disorder giving the outward appearance of a crooked jaw. Left untreated for too long, severe tooth breakage could occur, along with gingival lesions, damage to the tmjoints. In typical cases of this magnitude, surgery is usually indicated, along with traditional orthodontics.

Treatment recommendations could include orthognathic surgery, oral surgery, palate expansion, orthodontic teeth realignment (after surgery). Other possiblities, in an effort to avoid invasive surgery could include combinations of orthodontics, bridgework, crowns, implants and porcelain laminates (veneers).

Crooked Jaw Occlusion
Crooked Jaw - Severe Crossbite
Ara Nazarian, DDS






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