Orthodontics 20 years ago often involved extractions, surgeries, lengthy treatment times, extraoral devices (like headgear) and clear aligners (Invisalign) were just starting to be developed. Now, preventative evaluation, materials advancements and new techniques provide new treatment may also be possible!
Crowding can present generalized throughout the arch, localized to a particular region in the arch form, and also vary from upper to lower arch. Some factors to consider in crowding evaluation of the developing dentition are size of teeth, arch shape, supporting bone and tissues, arch symmetry, order of eruption, direction of erupting teeth, and rotational position of teeth. Once the crowding assessment is determined, then this information is applied to other factors to best manage the crowding for each patient. These additional factors include: chronological age, dental eruption schedule, jaw growth pattern, family history, impaction risk, and anterior functional arrangement (overjet, overbite, coordination). With this assessment, orthodontic treatment options, timing recommendations, and risks/benefits of a phase I treatment or waiting for more growth and eruption of teeth can be advised.
