Can a Very Wide Dental Arch Can Be Narrowed? (photo)

Question

A few weeks back I posted about how I was unhappy with the facial changes my daughters braces had caused. Her teeth look pushed back and her lips smaller. Well, I sought a second opinion and was told that the reason was that she has been given a VERY wide dental arch - so wide that the back molars are spaced apart! On top of that her bite is open! I was told that due to the unnatural arch, she will ALWAYS need her retainers. My daughter is 13 and half - menarche started 2 years ago so she won't be growing for too much longer. THE PROBLEMS ARE THIS: 1st contact is on 1st molars, both sides (making it very hard to keep clean) - The front teeth do not touch when biting down (open bite) - The front teeth are biting edge to edge (minimal overbite) - Appearance wise - the corners of her mouth have been pushed forward so that the lips are not as full looking as before. What can be done about this?

Lance Timmerman, DMD, MAGD · Answer

I hate to say it, but many dentists don't know what they don't know.  Without photos I wouldn't even try to guess.

	 

	i suggest seeing 2 other orthodontists for opinions.  How old is the daughter?  Facial development is still happening, likely will look normal later.

Brad Lockhart, DDS · Answer

In 20+ years of treating patients and seeing patients that were treated by other doctors I have NEVER seen an overdeveloped arch. I see underdeveloped arches all day every day but the chances of your daughter's arch being overdeveloped is slim to none. Without photos it's impossible to comment further but I would be extremely careful before allowing anyone to narrow her arch. Properly developed arches are absolutely critical to not only have straight teeth but a healthy airway and TMJ.

	Good luck!

	Now that you have provided some photos I see that indeed your daughter's arches are NOT overdeveloped. If the arch development was done rapidly then it is possible that the results will not be as stable as if the development had been done slowly so relapse without using retainers is possible. 

	It sounds like some "settling of the bite" needs to occur followed by a simple bite adjustment. The "spaced apart" molars is not the result of arch development but probably from wearing molar bands during treatment. This will also resolve after "settling of the bite" occurs. As far as your daughter being unhappy with lip support I can't really comment without before and after pictures; but again, this would NOT be caused by an overly developed arch. I see patients all the time who come to me after receiving treatment somewhere else who complain of inadequate lip support but these patients always have an underdeveloped upper arch and usually over retracted upper incisors (commonly the result of extraction orthodontics). By the way, it was a GREAT decision NOT to have any of your daughter's teeth extracted.

	Good luck!

Can a Very Wide Dental Arch Can Be Narrowed? (photo)

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Can a Very Wide Dental Arch Can Be Narrowed? (photo)

Answers (2)

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Everything you need to know about Braces

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