Should the condition of bone be checked before aligners?

Question

Hi doctor,

I am 35 years old. I have deviated nasal septum due to which I have mouth breathing, which causes protruding teeth. My bite is fine. Just the front four to five teeth are protruding. I am considering going for clear aligners but want to check on the following. Do aligners cause any breathing problems since I do have mouth breathing issues? Any gum or teeth related challenge even if the hygiene is taken care of well? Does my gum and teeth strength need to be evaluated in any way to go in for aligners? If so, how? What are the chances for the teeth to bounce back to the same structure as now post the aligners? Due to my age, does it affect the effectiveness of the treatment? I have never had any teeth complications, no cavities, gum problems, and bite issues. The dentist has told me that the teeth are well maintained.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and images (attachment removed to protect patient identity). Teeth and soft tissue gingiva looks healthy and fine. There is minor posterior crowding in the lower arch. Minor proclination of anterior teeth. There are mild plaque and calculus deposition that need to be taken care of by scaling. Yes, mouth breathing habit leads to proclination of teeth. It is always better for permanent results to treat the cause of mouth breathing, and then orthodontic treatment will give you permanent, long-lasting results. Please upload an image of your face while smiling and with a relaxed posture to notice the proclination and your profile. If you want to go for aligners, then after visiting an orthodontist, you will come to know how your teeth will look after treatment with aligners. Aligners will have one app that shows the video simulation of your teeth before and after treatment. Your orthodontist will help you with that, do not worry about that. There is no such side effect of aligner for mouth breathing problems (clinical evaluation necessary). Your gingival bone health should be good for undergoing any kind of orthodontic treatment. If there is good bone, gingival, and dental condition, then age does not affect orthodontic treatment. When there is the removal of the cause, there will not be a bounce-back of orthodontic treatment results.

Answer 2

Hello,

Welcome back to icliniq.com.

The gingival condition can be checked by clinical examination. The bone condition can be checked by clinical examination and mainly with the x-ray called OPG (orthopantomogram). Usually, orthodontists suggest OPG before starting treatment as it will suggest bone condition and root alignment. Orthodontists are experts in the alignment of teeth. As I have advised before, it will be better to upload a profile image and face while smiling and without smiling.