Tilted premolars and buccal corridor. What are my options to fix this? (Photo)

Question

I had upper and lower palate expansion as a kid but didn't consistently wear my retainer. My front teeth have shifted a bit but I'm more bothered by the gaps at the side of my smile. My premolars tilt inward quite a bit, especially on one side, which I think is a factor. What are my options to fix this? Could I have an appliance just to tilt those teeth out that wouldn't be visible? Or would it be more worth it to do something like Invisalign to straighten the front teeth too?

Desiree Yazdan, DDS · Answer

Hi there. Just so you know, teeth are always moving. Unless you wear an appliance at night that will hold them in place such as a retainer or night guard, the daily forces placed upon teeth will cause them to shift constantly.  Based on the information you provided, Invisalign (or even other orthodontic treatments) would be a better option to get the desired alignment that you would like.

Raj Kumar, BDS, LDSRCS · Answer

Tilted premolars usually create a negative space such as the buccal corridor. This can be due to previous orthodontic relapse, midline suture relapse of the palate or simply dental arch constriction due to clenching etc.Invisalign would be ideal to push out the premolars, reduce the space and also improve the anterior smile.

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