Thursday, February 20, 2020

Is it genetics? Environment? Our Diet? Aging? Or the dentistry in our mouths?

The answer to all the above is yes.

Over 60% of us are born with the genetics to develop crooked/crowded teeth. And for most of the rest, it develops over time.

For the small percentage of you who were blessed with straight, aligned, beautiful teeth, smile and turn the page. I hope to grab you next month with a different topic. Or, keep reading because chances are your spouse and/or your children are not as blessed as you.

So, let’s look at each idea and discuss.

Genetics definitely plays a role in all aspects of our development. I am fortunate to see large families spanning four generations in my practice. I’ll see the the great grandparent in their 90s and the grandchild who is nine. Missing teeth, rotated canines, crowded teeth and jaw development are apparent patterns recognized in these families. So, yes, genetics is there. It definitely plays a part but I don’t feel it’s a major factor.

Another possible major factor to consider is environment or nurture. Those who have difficulty breathing through their nose cause increased mouth-breathing. This can be a result of environmental air pollution, frequent respiratory infections or tonsil problems. The muscles around the mouth region continuously constrict with mouth-breathing thus exerting a force on the teeth, pushing them inwards. Over time the upper and lower jaw can become narrowed and restricted, forcing mouth breathing and crowding of the teeth. In addition, oral habits such as thumb-sucking, reverse swallowing and tongue thrusts all impact jaw and teeth development.

I have discussed in the past the impact of our modern diet on our mouths, mostly related to tooth decay. However, there are many who believe that the 21st century American diet is a huge contributor to oral development. For example, foods that contain refined sugars and gluten are said to inflame the inner lining of the nose in some, and cause mouth breathing which leads to crowding. Dr. Weston Price did extensive research regarding the lack of broad jaw development allowing space for teeth as being entirely nutritional. Without essential nutrients, vitamins and fats found in primitive diets, the jaw and palate cannot form with enough strength, hence narrowing the face. Others believe that our soft diets don’t allow us to build our jaw muscles or that we tend to hang our lower jaws open more, thus leading to narrowness. A classic sign of frequent mouth breathing is chronically dry lips all year round.

And yes, there is the age factor, I believe that the way we age in our mouths is that our teeth begin to wander. They say “everything goes south,” well in our mouths, that occurs as well. Our gums recede, and our teeth crowd and rotate. The most common area is the lower anterior teeth. Look around, many have crowded, overlapping lower front teeth (if we haven’t corrected them yet).  It’s sometimes called “medial drift” or just that teeth migrate forward through the years. This is how our teeth “wrinkle and sag.”

Finally, what about our dentistry? Well, many of us have corrected our teeth at younger ages, and now we see relapse.  Many have missing teeth, and then the others start to shift, rotate and look for their “friends” that have gone. Teeth needs buddys, top and bottom, left and right.  When they are on their own, they wander. Have you found that teeth that used to be in contact have, over time, developed spaces?  Furthermore, if they have been restored, and the bite or contacts between them are not right, they move as well. Improper occlusion, or the pattern in which your teeth come together, can cause jaw pain, TMJ symptoms and tooth problems.

I hope I have raised all of your dental IQs regarding crowding. However, do we need to fix them? My answer, in most cases, is yes. Why? Firstly, in this day and age, we all like straight pearly white teeth. So, aesthetically it’s worth it. With Invisalign and orthodontics it’s fairly easy and comfortable, and the results are enjoyable. And, secondly, for form and function it may be essential for our, and our children’s, development for a healthy oral future.

So, discuss the options with your dentists, but now you can have a more academic discussion to understand what’s going on in your mouth.

Please email me any questions you may have so I can work on developing future articles that will address your interests at This email address is being protected from spambots. You need JavaScript enabled to view it.. Thank you.

By Brian M. Kalb, DDS

Dr. Brian Kalb practices Dentistry in New Rochelle and Long Island . He can be reached at 914-262-1399 or

Join Our List
and receive information on community events, announcements, exclusive sales and our issue emails.