Clinical Assessment & Presentations
Intra-oral Features
Early loss of space and ectopic teeth
Mild crowding usually presents at the incisor region of the upper and lower arches. It can be defined as crowding which has less than 4mm of tooth size to arch size discrepancy. The aetiologies are discussed in the crowding diagnosis.
Moderate crowding is where there is 4 to 8mm of tooth size to arch size discrepancy. It can be seen in the anterior region as rotated or overlapped incisors posteriorly with buccal or lingually displaced teeth. The aetiologies are discussed in the crowding diagnosis.
Severe crowding is where there is more than 8mm of crowding. It can present itself with severe malalignment of teeth, including teeth which can be blocked out of the arch form. Associated problems such as crossbites or functional shift are common with cases of severe crowding. The aetiologies are discussed in the crowding diagnosis.
In moderate to severe crowding, the early loss of deciduous teeth and drifting of posterior teeth can cause displacement of teeth which erupt later in the mixed dentition stage. Common teeth to be displaced are canines and premolars. A buccal displaced canine is a common sign of severe crowding.
Posterior crowding
Posterior crowding can present with impacted posterior teeth such as impacted first, second or third molars. These can be visible clinically and patients may present with pericoronitis, plaque-retention, and sometimes discomfort. Posterior crowding is just as valid as a treatment indication as anterior crowding.
Late incisor crowding
Late incisor crowding is considered tertiary crowding and can be mild to severe in presentation. It often occurs in late adolescence and can continue several decades into adulthood. It is present on the lower arch in both treated and untreated individuals, and may exist in all types of facial patterns. The aetiologies are discussed in the crowding diagnosis.
