RealSelf Verified doctors complete our multistep verification process to ensure they are in good medical standing, display their experience and most performed procedures, have high patient satisfaction ratings, and respond to consultation requests quickly. Just look for the RealSelf Verified badge.
FIND A VERIFIED DOCTORClaim your profile now— it costs nothing! Build trust by highlighting education, board certifications, and hospital privileges. List treatments, and include all procedures you perform. Get involved by uploading before & after procedure photos and answering questions from prospective patients.
CLAIM YOUR PROFILEBased on your photos, lingual braces or invisalign® should be excellent options for your concerns. If you are traveling a great distance for your treatment, Invisalign® may be the better option. Tooth movements can be programed during the digital setup of your prescribed tooth movements with invisalign® to accommodate your travel schedule. Problems that may arise with fixed orthodontic appliances may be difficult to address quickly and your treatment time may be prolonged.
I hope this information was helpful.
Dr. Cassalia
Orthodontist
Braces are definitely an option. I would recommend a consultation with your local orthodontist to discuss your concerns and available treatment options. Alternative treatment options may include clear aligner therapy like invisalign®, removable retainer like devices (inman aligner), lingual (behind the teeth) braces, or other specialty techniques that align the anterior teeth (see attached video).
I hope this information was helpful.
Dr. Cassalia
Orthodontist
The general appearance of your bite and smile line look good. It is hard to tell from the photos but there is most likely a midline shift toward the left of the facial midline due to the missing bicuspid.
If your main concern is your lower arch crowding, then there are several options you may want to consider. If you are looking for cosmetic options to align your teeth, Invisalign® or lingual treatment options are a consideration. There are some specialty lingual techniques available but are not provided by many practices that provide orthodontic treatment (see attached video). Personally I would not remove a tooth in your case but would recommend a slight amount of IPR. For a case like yours, I would estimate total treatment time to be 8 to 10 months to align the lower anterior teeth.
I hope this information was helpful.
Dr. Cassalia
Orthodontist
The small gap between your teeth is a “cosmetic” issue. It may not be necessary to close the space for any health related concerns but you are self-conscious of the space and it concerns you. If your dentist is not willing to discuss treatment options for your dental and cosmetic concerns, get a second opinion. Options may include full or limited orthodontic intervention or restorative dentistry in the form of bonding or veneers to close the space. You can also have a consultation with an orthodontist to discuss treatment options.
Based on the photos you provided, there appears to be spaces on both the upper and lower arches. Orthodontic treatment may be required on both arches to correct the spacing on the upper. The other factor to consider is maintaining the space closure. Long term retention may be required with a lingual bonded retainer (fixed retainer behind your teeth) if orthodontic treatment is recommended.
I hope this information was helpful.
Dr. Cassalia
Orthodontist
There are a number of things to consider when a small space such as yours is a cosmetic concern. If the space is due to a tooth size discrepancy (teeth are small relative to other teeth), then bonding or veneers may be a viable treatment option.
Orthodontic treatment with braces or clear aligner products like Invisalign® may also be an option. I would recommend discussing your concerns with your dentist and have a consultation with an orthodontist. They can evaluate your situation and concerns and recommend the optimal treatment plan.
There are limited orthodontic treatment options available that can address small spaces when bite conditions are ideal (See attached video reference). I am not exactly sure what you mean by the “bands” but once again your overall tooth and bite relationship should be evaluated and treatment monitored by a dental professional.
Another thing to consider is maintaining the space after closure. Orthodontic intervention may require permanent retention. Be sure to discuss long term retention options with the orthodontist.
I hope this information was helpful.
Dr. Cassalia
Orthodontist
In any case, braces are typically the best option for aligning your teeth. There are several other cosmetic options such as clear aligner products (invisalign®) and lingual (behind the teeth) options. In my experience, most patients that had facial or visible braces that experienced relapse would like to consider the cosmetic options to re-align their teeth.
Another factor to consider is the plan for retention. A removable retainer works well when worn as prescribed. I think most orthodontists would agree that long term and possibly life time retention would be required to maintain the alignment of your teeth. There are many different factors that may be responsible for tooth movements over the years.
A permanent bonded lingual (behind the teeth) retainer may also be considered in your case. I would recommend discussing re-treatment options and long term retention options with your orthodontist.
I hope this information was helpful.
Dr. C
Orthodontist
It is possible to just straighten your lower teeth. However there are many factors to consider when treating a single arch such as your bite relationship and the possibility that the position of the upper teeth may interfere with the movement of the lower teeth.
I would recommend having a consult with an orthodontist to discuss your concerns and treatment options. There are many different treatment modalities that are available and they will provide the optimal treatment recommendation. If your concerns are limited to the anterior part of the arch, there are some limited lingual (behind the teeth) options and limited clear aligner systems (invisalign® express) that you may want to consider.
I hope this information was helpful.
Orthodontist
Invisalign® should be a viable option in your case. I would recommend having a consultation with an orthodontist to discuss your treatment options. It is possible that your case may require only a few aligners and could be submitted as an express case of invisalign® which is typically less expensive. In reference to the question of effectiveness, Invisalign® does have some limitations with certain tooth movements. The crowding of the lower arch should not be a problem using aligner therapy. Vertical movements and leveling of your upper teeth may be a challenge. There are techniques that are used with clear aligners that address these difficult movements. I would recommend discussing these concerns at the consultation. I hope this information was helpful. Dr. C
Orthodontist
Lingual braces may be a viable option in your case. I would recommend having a consultation with an orthodontist that specializes in Lingual orthodontics. Dr. Jeffrey Twohig provides lingual braces and other specialty lingual treatments that might interest you. His office is located in Fond Du Lac WI.
Dr. C
Orthodontist
Limited treatment options to align your 4 front teeth should not take long (4-6 months). Overbite correction is usually more involved and typically requires more time to correct depending on your situation. Invisalign® or lingual braces may be excellent treatment choices if you are looking for aesthetic treatment options.
I would recommend a consultation with an orthodontist to discuss your concerns and treatment options. Treatment consultations are sometimes complimentary and they can discuss treatment options, length of treatment and cost.
If your main concern is the four front teeth and you are considering limited lingual treatment options, then you may want to consider a fixed procedure that is available and does not require braces. Please see the attached video and web reference. Dr. Chris Pine is very familiar with this procedure and has an office located in Tyrone PA.
I hope this information was helpful.
Dr. C
Orthodontist
I was lucky enough to have a wirelign system developed by Dr. Cassalia in Chalfont, PA placed on the back of my upper and lower teeth. As you see my youtube video as well as the photos posted I have crowding in both my upper and lower teeth. The crowding in the lower teeth was more bothersome to me but Dr. Cassalia had a sincere desire to make my smile as beautiful as possible (you can tell he is a perfectionist and I love it!) so I decided to get both my top and bottom teeth wireligned. From the moment I walked into Dr. C's office I felt so welcomed and surrounded by knowledgeable, skilled and professional people. After seeing the amazing before and afters of prior patients It was clear to me that I was committed with going forward with the process of wirelign. Some of Dr. Cassalia's coworkers have gotten wirelign and you will see their beautiful results when you visit the office. It is truly amazing. Check out before and afters at his website. The process of getting the wires placed on my teeth was pretty easy and nothing I wouldn't expect. Photographs we taken, x rays done and then Dr. C had me lie in his chair as he delicately placed wire around each tooth that needed to move in order to correct crookedness and crowding. The process was not too uncomfortable- it felt similar to having braces tightened. He used a light to bond the wire to the teeth which felt warm. When he finished my teeth felt like they had a slight pressure on them. Nothing I couldn't handle...especially since I've had full braces in the past. My next appointment is in 1 moth to reactivate the wire. Judging by the process of the before and afters I looked at I wouldn't be surprised to see some slight movement in my teeth. My treatment plan is for 10 months but in the before and afters there is often movement after just 2 months. Hope that happens! I will keep you updated on pictures, photos and videos about the process. I think Wirelign could be amazing for orthodontics and amazing for my smile. Send me your questions and comments!:) Updated on 15 Jun 2016: Just wanted to post some pictures of what Wirelign actually looks like on teeth. I got my wire placed yesterday. The wires are not at all visible on the front of teeth and only slightly visible form the back (I even let my mom look inside my mouth on the backs of my teeth and she couldn't see it)https://www.youtube.com/watch?v=8J_Xygk4nGU&feature=youtu.be Updated on 16 Jul 2016: So it's been one month since I had my wires placed and I got them repositioned and tightened 2 days ago. My teeth are already dramatically straighter. I'm pretty thrilled! I'm so happy I went forward with this process. There's still some work to done and Dr. C is going to correct my arches using a special wire he developed but so far I'm supper excited with the results and it's only been a month:) Yay! The results were so dramatic that for a second I forgot which side of my lower teeth originally had the crowding! Lol. I hope people considering other methods get access to this process- it's so great:) send me any questions! Updated on 16 Jul 2016: Just a side by side show 1 month of progress. Updated on 12 Aug 2016: Here is my update at months. I had my wire tightened again earlier this week. I continue to be amazed. My top teeth are now almost completely straight...I am getting prowire at my next visit so that we can start the process of correcting my arches. All in 2 months- invisible, no trays, buttons or braces. I couldn't be happier! See my videos for more details about he process and feel free to send me your questions.
What’s trending? Who’s turning heads? Which TikTok myths need busting? We’ve got you. No fluff, no gatekeeping—just real talk. Get our free, unfiltered newsletter.