Case Study: Dental Problems Can Re-emerge In Adulthood

Many people start orthodontic treatment as teenagers. Because of this, there is a misconception that after the teenage years, teeth will stay put. As with other areas of the body, teeth can change as a teenager grows into an adult and dental problems can re-emerge. This case study is an example of changes adults can notice as they mature. Hear more from Kelsey.

Patient. Kelsey came to Baltimore Orthodontic group in 2020 seeking treatment for her anterior open bite. She had previously received orthodontic treatment as a teenager, including premolar extractions and an expander.

Problem. As Kelsey grew to adulthood, the open bite and posterior crossbite re-emerged.  At this stage of adulthood, Kelsey was presented with two distinct options. 1) She could be treated with a course of Invisalign braces. This treatment would improve her teeth position but not perfect the bite. Or, 2) she could undergo full treatment with accompanying orthognathic surgery (corrective jaw surgery) to produce a "textbook perfect" smile. Kelsey chose the latter – with stellar results!

Solution. Kelsey presented with generalized crowding, a posterior crossbite, and an anterior open bite that was partially the result of a forward tongue posture. Kelsey was prescribed myofunctional therapy, a form of physical therapy that addresses tongue habits, in order to help close the anterior open bite. The next step was to address tooth movement  with Invisalign. From there she transitioned to braces prior to the surgery to further encourage the movement of a few stubborn teeth.

Process. Orthognathic surgery was planned for several reasons. First, it was important that her upper and lower jaw were in harmony to address the posterior crossbite. Secondly, the surgery was crucial to closing the anterior open bite and providing the maximum stability to retain the position of the teeth.

Result. Kelsey's treatment, while a big commitment, yielded similarly giant results! At the completion of orthodontic movement, her general dentist placed new molar crowns on the lower left side to complete an ideal bite. We were able to set up the adult teeth to make it easier to care for her teeth and gums long-term. Kelsey's case is a wonderful example of how multidisciplinary care between different types of dentists – general dentists, orthodontists, periodontists, and oral surgeons – can contribute to ideal dental esthetics and health. We are so happy for her!