Orthodontic Problems and Solutions

Cases are presented here to illustrate different kinds of orthodontic problems and options for their correction. This is not necessarily a showcase for my treatment expertise (although many of the cases that I am displaying here are difficult and I am proud of the results). More often than not, orthodontists will only show cases where the results are close to ideal. As anyone involved in the practice of medicine will tell you, the human body is not obligated to respond the way we think it is supposed to. This is why we need to discuss the risks of treatment with you before treatment is started. This area of the site is meant to help my patients understand the possible treatment options and outcomes for their type of problem. Unless otherwise noted, you may assume that the patients presented here were treated by me.

Excessive Overbite (vertical overlap) and/or Overjet (horizontal overlap)

Impacted Teeth 


Open Bite Due to Thumb Sucking

Congenitally Missing Teeth

This refers to teeth that were missing at birth (never had the genetic potential to form). Options are to 1) replace the missing teeth prosthetically (bridge, implant, removable appliance); 2) close the space orthodontically. Leaving the space where the tooth is missing is not a good option; the adjacent teeth drift into the space, frequently causing periodontal and bite problems.

Early Treatment for Cosmetic Reasons

Early treatment refers to orthodontic treatment that takes place before the patient would otherwise be ready for comprehensive treatment. Sometimes, this is necessary to prevent a problem from getting worse, or to intercept a problem that is compromising the health of the patient. In some situations, early treatment is not medically necessary, but the patient and/or parents are concerned enough about the appearance of the teeth that they want to treat early for cosmetic reasons (usually to align the front teeth).


The options that we as Orthodontists have available to us to create space are 1) increase the size of the arch that the teeth need to fit on; 2) make the teeth more narrow to fit on the existing arch form (this is done by removing enamel from the contact area. This is commonly referred to by Orthodontists as stripping, inter-proximal reduction or IPR or slenderizing. I usually refer to it as stripping.); 3) extracting teeth; 4) combinations of the above.

Transposed teeth

A transposition refers to a situation where teeth have switched positions. There are most commonly two options: 1) leave the teeth transposed; 2) correct the transposition.


This is a general term that refers to any teeth that are not aligned on an ideal arch form. The teeth could be rotated (twisted), to the inside or outside of the arch form, forward or backward of their ideal positions, or any combination of the above. All else being equal, misalignment problems are relatively easily corrected with braces.

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