Dental crowding occurs when a tooth or teeth shift out of position and cross over other teeth that are in the correct position. The crowding can cause bite issues, chewing difficulties, and cosmetic concerns. When the crowding teeth are the molars and premolars, which combine to form the grinding forces for your chewing, the difficulties are mostly in the chewing and holding your mouth together comfortably.
How can a dentist treat a crowding problem in the premolars and molars?
If you are young enough that the teeth are still erupting and shifting, or if the crowded teeth aren't severely crowding, your dentist might recommend simple orthodontics to correct the problem. Metal braces or invisible braces can both help fix the problem with the latter typically more popular with adult and older patients.
Clear braces have trays that fit snugly over the upper or lower half of the jaw that contains the crowded teeth. The orthodontist will schedule frequent follow-up visits to monitor the progress of the molars and to craft new trays based on that progress. You can remove the trays while eating or sleeping but leaving the trays in as much as possible will speed up the treatment process for your crowded premolars and molars.
The molars and premolars are rear enough in your mouth that the loss of a tooth isn't highly noticeable when you smile. If your dental crowding is mostly caused by a singular tooth way out of position, your dentist might opt to simply remove that tooth.
The remaining molars and premolars might now have the proper positioning or might find that positioning easily with a short treatment of orthodontics. The loss of the one tooth shouldn't cause substantial bite issues after the remaining teeth are in place.
There are also rare instances when an extra molar erupts and causes the crowding. In those cases, extraction is the answer and won't cost you any of your normal natural teeth.
The premolars and molars are sometimes crowded due to a section of the jawbone leaning in the wrong direction. Even orthodontics won't fully treat the crowding because of this underlying issue. If your dentist discovers a jaw abnormality, jaw surgery will be performed to correct the issue.
Once the jaw surgery is completed and healing has finished, the dentist will evaluate the current state of the crowding. Orthodontics or extraction might still be necessary but will now work properly since the jaw is in the right place.