Best Way to Close a Wide Gap, Braces or Aligners?

Question

I have been living with this for 28years now.Though,when i was 9years the gap wasnt all that wide. Now a 10months old finger can pass through it. I have been ignoring the look, it hasnt giving me confident smile since i started having concern about it. Pls,what is the best optional treatment my widened gap....braces or aligner. Also, there is thick frenulum in between the upper front.

Greg Jorgensen, DMD, MS · Answer

I use a lot of aligners in my practice (specifically Invisalign) and I have closed a lot of spaces with them. So it is possible to close spaces between the teeth using only aligners. Having said that, aligners are not always predictable in the way that they can control tipping of the teeth and the final angulation of the crowns and roots at the end of treatment. Since the space is right in the front of your smile, I would recommend the control offered by braces. If you are really concerned about how you'd look with metal braces during your treatment, talk to your orthodontist about using clear brackets. I think you'll be happier with the final result choosing the braces option.

Jacqueline Demko, DDS, MSD · Answer

I biggest issue here isn't can it be done. It is how will it stay closed. Something created it. That should be determined first. It often is a few things. It could be a freum, tongue thrust, tongue size, etc. Each should be carefully looked out.

	Both Braces and Invisalign would be a consideration. If it's your frenum you'll need a frenectomy. If its a tongue thrust you'll need therapy. If it is a tongue size you can have your tongue made smaller-ooch!!

	Either way retainers retainer retainers

R. William McNeill, DDS, MS · Answer

THE DEGREE OF SPACE THAT YOU SHOW IS LIKELY TOO EXTREME TO SUCCESSFULLY CLOSE WITH ALIGNERS. MY GUESS IS THAT IF SUCH TREATMENT WERE ATTEMPTED THE SPACE WOULD BE ONLY PARTIALLY CLOSED AND WOULD BE DONE BY TIPPING THE TEETH WITH A MINIMUM OF ROOT MOVEMENT. ALL SPACES OF THIS TYPE ARE DIFFICULT TO KEEP CLOSED UNDER THE BEST OF CIRCUMSTANCES. DOING IT BY TIPPING THE TEETH WOULD ONLY COMPLICATE MATTERS. YOUR BEST BET IS TO OPT FOR BRACES!

Robert Waxler, DMD, MS · Answer

It looks like you have a tongue size/position problem that is causing your teeth to migrate forward and apart.  Not much you can do about the tongue but once the teeth are retracted wearing a retainer every night, forever should keep the spaces from comming back.  Not sure if you will need the frenum removed...wait until the space is closed and see.

	Invisalign is a great appliance for your type of problem because it "blocks" the tongue action and makes the space closure much easier than braces.

	Remember...retention forever or don't even think about treatment!

Gordon Chee, DDS · Answer

Those look like pretty large gaps. I would recommend braces at this point. It also looks like besides having gaps, there are some crossbite issues with your left canines and lateral incisors to correct as well.

Best Way to Close a Wide Gap, Braces or Aligners?

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