If two people both have crooked teeth, they should need the same treatment, right? Not quite.
At Fresh Orthodontics in Park Slope, orthodontist Dr. Ankush Khanna creates custom orthodontic treatment plans for every patient because straightening teeth is only part of the equation.
The bigger question is: What’s causing the teeth to be crooked, and how do the upper and lower teeth fit together (i.e., the bite)?
That’s why the best orthodontic treatment plans don’t just focus on alignment, but also take into account your bite, jaw development, facial features, and long-term oral health.
Crooked Teeth Are Only Part of the Story
Sometimes, when patients ask how to fix crooked teeth, they’re thinking about appearance. They want teeth that look straighter and more balanced when they smile.
And that matters, of course. But orthodontic treatment goes beyond cosmetics.
Dr. Khanna also evaluates:
- How the upper and lower teeth come together
- Whether the bite is healthy and stable
- Jaw size and positioning
- Facial balance and profile
- Tooth wear, gum health, and oral hygiene
- TMJ and chewing muscle function
- Airway and breathing patterns (in kids)
- Whether the patient is still growing
The goal is to achieve a smile that’s as functional and healthy as it is beautiful.
What Is the Bite, and Why Does It Matter?
Your bite is the way your upper and lower teeth fit together when you close your mouth. In a healthy bite, the teeth meet comfortably, and the forces from chewing and biting are distributed evenly.
A bad bite, also called malocclusion, can involve the teeth, jaws, or both. Common bite problems include:
- Overbite: The upper front teeth cover too much of the lower front teeth.
- Underbite: The lower teeth sit in front of the upper teeth.
- Crossbite: Some of the upper teeth sit inside the lower teeth.
- Open bite: The upper and lower teeth don’t overlap properly or, sometimes, don’t touch at all.
- Overjet: The upper front teeth stick out too far.
- Crowding: There isn’t enough room for the teeth to align properly.
- Spacing: There are gaps between the teeth.
Two patients can both have “crooked teeth,” but if one has a healthy bite and the other has, for example, a crossbite or underbite, their orthodontic treatment plans will look completely different, as we’ll discuss below.
Example 1: Crooked Teeth With a Healthy Bite
Let’s say an adult patient had braces in their teen years, got lax about wearing their retainer, and now has mild crowding in the front teeth. However, the upper and lower teeth fit together well, and there are no major functional concerns.
In this case, Dr. Khanna may recommend limited treatment with Spark Aligners. Using digital orthodontics, he can map out the exact tooth movements needed to straighten the teeth while preserving the patient’s healthy bite.
This type of treatment is shorter and relatively straightforward because the main goal is alignment and smile design, not the correction of a significant bite problem.
Example 2: Crooked Teeth With a Bite Problem
Now imagine another patient with crowded teeth, but they also have a crossbite, overbite, or underbite.
While crooked teeth may be the most obvious concern, bite problems can affect chewing, tooth wear, gum health, jaw function, and even facial balance.
In these cases, simply straightening the teeth isn’t enough. The treatment plan also has to correct how the upper and lower teeth fit together.
Depending on the patient’s age and the cause, type, and severity of the bite problem, treatment could range from Spark™ Aligners or braces with elastics to two-phase treatment with an appliance like a palatal expander in a child.
In certain adults with a skeletal bite issue, other appliances or, in severe cases, orthognathic (jaw) surgery could be part of the treatment plan.
Example 3: Crooked Teeth in a Child With a Jaw Discrepancy
Sometimes, a child’s teeth may look only mildly crooked, but the real issue is skeletal. For example, the upper and lower jaws may be growing at different rates, or the upper jaw may be too narrow relative to the lower jaw.
In these cases, Dr. Khanna may recommend Phase 1 orthodontic treatment while a child is still growing. Depending on the specific diagnosis, treatment could involve an appliance designed to guide jaw development, create space for permanent teeth, or improve the relationship between the upper and lower jaws.
Later, once all of the permanent teeth have erupted, Phase 2 treatment begins with braces or Spark™ Aligners to fine-tune tooth alignment and bite correction.
This is one reason early orthodontic evaluations are so valuable. When jaw discrepancies are identified at the right time, orthodontists can often guide growth in ways that aren’t possible once development is complete.
How Digital Orthodontics Helps Dr. Khanna Create Custom Smiles
At Fresh Orthodontics, digital orthodontics plays a huge role in diagnosis, smile design, and treatment planning.
During your consultation, our team will take digital records, which may include x-rays, photos, and scans. These allow Dr. Khanna to evaluate your teeth, gums, bite, jaws, and facial features in detail.
With digital treatment planning software, he can:
- Move each tooth virtually before treatment begins
- Plan the sequence of tooth movements
- Evaluate how changes will affect the bite and facial balance
- Simulate different outcomes
- Troubleshoot potential challenges in advance
- Design a smile that complements your lips, cheeks, profile, and facial features
The result is a healthy, balanced smile that looks natural, functions properly, and is uniquely yours.
What are the Phases of Braces or Aligner Treatment?
While every patient’s plan is different, there are usually three main stages of orthodontic treatment.
1. Planning Phase
This is where the behind-the-scenes work happens. Dr. Khanna evaluates your records, makes a diagnosis, and creates a custom treatment plan.
This stage is essential because it determines how and when each individual tooth should move, how the bite will be corrected, and whether braces, Spark Aligners, elastics, expanders, or other appliances are needed.
2. Active Treatment Phase
This is the stage most people think of when they picture braces or aligners. It’s when your appliance is in place, and your teeth begin moving into their planned positions.
The active phase may include:
- Aligning and leveling the teeth
- Closing spaces
- Creating space for crowded teeth
- Correcting the bite, using elastics or other auxiliaries
- Finishing and fine-tuning the smile
The length and complexity of the active stage of treatment depend on the severity of your case.
3. Retention Phase
Once the teeth and bite are corrected, you’ll get custom retainers to hold everything in place. This step is critical because teeth naturally want to shift over time.
Wearing your retainers as instructed protects your results and ensures your new smile lasts a lifetime.
Why Does Seeing an Orthodontic Specialist Matter?
Orthodontic treatment creates permanent changes in your teeth, bite, and sometimes facial appearance. That’s why diagnosis and treatment planning matter so much.
A direct-to-consumer aligner company or one-size-fits-all approach might focus on straightening visible teeth. But if the bite is ignored, the results likely won’t be stable, healthy, or functional.
As a certified specialist in orthodontics and dentofacial orthopedics, Dr. Khanna has advanced training in tooth movement, jaw growth, bite correction, and facial balance. He uses that expertise to create orthodontic treatment plans that are personalized from start to finish.
The Best Orthodontic Treatment Plan Is the One Designed for You
The bottom line? Two people with crooked teeth can require completely different orthodontic treatment plans because the underlying causes of their misalignment aren’t the same.
One patient may be a candidate for limited Spark™ Aligner treatment to address minor crowding, while another may need comprehensive treatment involving braces, bite correction, elastics, expansion, or even two phases of treatment beginning in childhood.
At Fresh Orthodontics, Dr. Khanna’s goal is to create a custom treatment plan that delivers a healthy bite, optimal function, and a beautiful smile designed specially for you.
Explore Personalized Orthodontic Treatment in Brooklyn
Wondering how to fix crooked teeth in a way that works for your smile, bite, and lifestyle?
Book a complimentary consultation at Fresh Orthodontics in Park Slope. Dr. Khanna will evaluate your teeth, bite, and facial anatomy and recommend the best orthodontic treatment plan for you or your child.
See why Brooklyn families have voted Fresh Orthodontics Best Orthodontist in Brooklyn for 7 years in a row!
