![]() It is difficult to prevent incisor crowding if it is noticed in the growing child. Very rarely if crowding is severe, a tooth maybe blocked from erupting into the mouth. It is also common to see incisor rotations as rotated incisor teeth take up less space that non-rotated teeth. Incisor crowding most commonly manifests as tooth displacement from the line of the arch. Originally, it was thought that eruption of wisdom teeth (third molars) may contribute to late lower incisor crowding, however, this is no longer believed to be the case as many people who do not develop wisdom teeth can develop late lower incisor crowding. The magnitude of these adults growth changes are small (1-2mm) however they are significant enough to cause movement in the lower incisors that results in crowding. Evidence would suggest that lower jaw growth occurs well into adulthood. Late lower incisor crowding is thought to be due to late lower jaw growth. The size of teeth may be increased (macrodontia) or there maybe extra teeth (supernumerary teeth) within the dentition. Both upper and lower jaws may be too small to accommodate all the developing teeth. Causes of incisor crowdingĮssentially, crowding is due to a mismatch between jaw size and tooth size. This has been termed "late incisor crowding" and its causes are discussed below. It is common to see patients who had perfect alignment in young adulthood to become gradually less well aligned with age. The incisors may also become crowded with normal age changes. In reality the evidence is inconclusive and both factors may play an important role. In modern times the problem of incisor crowding may have increased and this has been largely attributed to a number of factors: (1) a gradual reduction in jaw size caused by modern day diets that require less jaw activity to break down food and (2) genetic mixing of populations which has resulted in a mismatch between jaw size and tooth size. It is one of the most common reasons for patients to seek orthodontic treatment. Incisor crowding can have a significant effect on the appearance of the smile and can, in some cases, make it more difficult to keep the teeth clean. By Daljit Gill BDS, BSc, MSc, FDS RCS, M.Orth, F.Orth RCS (Eng) Consultant Orthodontist, UCLH Eastman Dental Hospital, London UK.
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