As teeth shift out of alignment, which can happen for a number of reasons, they can give way to a smile that has seen the test of time. According to Powell, OH, cosmetic dentist Neal Patel, DDS, even the healthiest patients can experience teeth that slightly shift and drift. “Crooked teeth make you look older because we generally associate straight teeth with a youthful, healthy mouth,” says New York cosmetic dentist Irwin Smigel, DDS.
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Why teeth shift
Our teeth shift with age due to a lack of bone strength. “The teeth aren’t as strong as when they were younger,” says Dr. Smigel. Even if you had braces as a teenager, conditions can develop that affect the gums, forcing shifting to occur. If you are genetically blessed with naturally straight teeth and you never needed orthodontics, it’s still possible for your teeth to shift. When the bone that holds teeth in place is lost or spaces arise from missing teeth, the teeth move into the empty spaces. “The bone can also shrink, causing teeth to become loose and drift,” says Dr. Smigel. Add in years of wearing fillings and crowns, coupled with the repeated movements made from chewing and clamping down on the teeth, and shifting is inevitable. “Another cause for shifting is gum disease,” says Dr. Patel. “While it’s not usually painful, it can force teeth to become crooked and rotated because the gum pulls away from the tooth.”
How to prevent it
If you have retainers, wear them. “Even if you never had braces or have not had them for a long time, ask your dentist to fit you for a retainer to keep your teeth from shifting,” says Mt. Pleasant, SC, cosmetic dentist Nicole Dahlkemper, DMD. Regular cleanings are the most effective way to prevent bone loss. Missing teeth, which age the smile tenfold, also cause your other teeth to shift, so it’s important to restore them. “If a tooth is extracted it must be replaced with an implant or bridge because nature abhors a vacuum and even healthy teeth will move to fill in the space,” says Dr. Smigel.
What to fix first
If gum disease caused shifting, the issue needs to be corrected before any cosmetic work is done. “The gums will continue to cause problems if the underlying issues aren’t corrected,” says Dr. Patel. Then, once the gums are under control, the teeth can be straightened with braces or Invisalign.
Align your smile
For teeth that have shifted minimally, removable aligners like Invisalign can be used. “Invisalign is one of the best ways to straighten teeth. It returns teeth to the right positions through slow, controlled movements,” says San Francisco cosmetic dentist Niloufer G. Hamsayeh, DDS. Adult orthodontics not only create a better bite, but they also lead to better functioning teeth. “Crooked teeth invite gum inflammation and recession,” says Beverly Hills, CA, cosmetic dentist Laurence R. Rifkin, DDS. “Straightening them makes them easier to clean and reduces inflammation.” Advanced shifting may necessitate conventional braces.