Is it normal for an overbite to worsen during braces treatment?Braces & Invisalign Cosmetic Dentistry
My overbite has worsened during the course of my braces treatment. I'm a little anxious as I feel that my orthodontist is more concerned with closing my gaps (I had 4 extractions) rather than correcting my severe overbite. Is it normal for an overbite to worsen during braces treatment? Is it the norm for an overbite to be corrected only after my extraction sites are closed?
Overbites tend to change as orthodontic treatment progresses.
Having an overbite is a normal feature of occlusion (the way your teeth bite together) and improving the overbite is usually a goal of orthodontic treatment. This may mean making a deep overbite (where the upper front teeth greatly overlap the lower front teeth) shallower; making a shallow/open overbite (where the upper and lower front teeth do not touch or overlap) deeper; and reversing an anterior crossbite (where the lower front teeth overlap in front of the upper front teeth).
Since 4 extractions have been selected for space creation (usually for severely crowded cases and/or to correct protrusion of upper and lower front teeth, also known as bimaxillary proclination), you are being managed with orthodontic camouflage. This is commonly done for adult patients with underlying skeletal or tooth size discrepancies that are being treated non-surgically. At the end of treatment, the teeth should look straight but any skeletal proportion issues will remain unchanged.
All orthodontic treatment proceeds in roughly this sequence:
1) Pre-alignment: Management of skeletal issues. Occasionally, space may be gained for correction of severe crowding by extractions and sectional braces during this stage.
2) Leveling and aligning: This may overlap with space closure.
3) Arch coordination: This is normally when the bite is refined. Further correction of deep or open bites is done at this stage.
4) Finishing: Improvements to minor tooth positioning.
5) Retention: Braces are removed and retainers are made.
Overbites can be influenced by the mechanics selected for space closure. Some mechanics are efficient at closing spaces but may produce side effects, such as opening or closing of the bite. Some of these side effects may be desirable (opening of a deep overbite) or may be undesirable.
Anticipation and simultaneous management of these side effects can improve treatment efficiency. This depends on the treatment style of the clinician and the training they received. Some prefer to deal with the bite at a later stage since space closure can take quite a long time in adults.
Trust in your treating clinician and maintaining a line of open communication throughout your treatment is essential for success. Only the person carrying out your treatment has full possession of the facts relevant to your case and can advise you appropriately.
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