Written by Dr. Jaclyn Toh
As a general dentist with a passion for restorative dentistry, I’ve found that integrating orthodontics into my treatment planning has transformed the way I approach complex cases. My journey into orthodontics started in 2016 when I realized that many of my restorative challenges could be better addressed by first optimizing tooth position. In this article, I’ll share five key ways that orthodontics can enhance restorative outcomes, improve function, and ultimately lead to longer-lasting, more predictable results.
Many patients present with worn-down anterior teeth due to deep bites, parafunctional habits, or poor occlusal dynamics. In the past, I would attempt to restore these teeth with bonding or ceramics alone, only to find that space limitations or unfavorable bite forces compromised the longevity of my work.
Now, I incorporate orthodontics to create proper incisal clearance before restoring worn dentition. By repositioning the teeth first, I ensure that my restorations are minimally invasive and have the ideal functional environment to last. This approach not only improves aesthetics but also protects the restorations from early failure due to excessive wear or occlusal trauma.
One of my favorite applications of orthodontics in restorative dentistry is canine substitution. When a patient is missing a lateral incisor, we can move the canine into its place and reshape it to mimic a lateral, rather than automatically considering an implant or bridge.
To achieve an ideal outcome, I use orthodontics to position the canine correctly, followed by composite or ceramic restorations to refine the shape and shade. This method provides a natural, long-term solution while maintaining the integrity of the patient’s existing dentition.
Before incorporating orthodontics into my practice, I often struggled with preparing misaligned teeth for crowns or bridges. When teeth are crowded or tilted, achieving an optimal preparation requires aggressive reduction, which can compromise the long-term health of the tooth.
By aligning the teeth first, I minimize the need for excessive preparation, preserving more enamel and ensuring that my restorations have better retention, fit, and aesthetics. This approach makes a significant difference in cases requiring multiple crowns or full-mouth rehabilitations.
When planning implants or bridges, orthodontics plays a crucial role in optimizing space and positioning. Teeth adjacent to an edentulous space often drift or tip, making it difficult to place an implant in an ideal position. By uprighting molars or redistributing space, I create a foundation that allows for more predictable and aesthetic implant and bridgework.
One case that stands out involved a patient with a missing central incisor and severe tipping of the adjacent teeth. Instead of proceeding directly to prosthetic work, I first used orthodontics to straighten and align the adjacent teeth, ensuring the implant would be placed in the perfect position for both function and aesthetics.
Even if you don’t perform orthodontics yourself, having a deep understanding of tooth movement can dramatically improve your ability to communicate with specialists. When I refer a patient for orthodontic treatment, I always provide calibrated photos, intraoral scans, and a detailed treatment plan outlining my restorative goals.
By clearly communicating the ideal tooth positions, midline corrections, or occlusal adjustments needed for my final restorations, I ensure that the orthodontist’s work aligns with my vision. This collaboration leads to better outcomes and prevents miscommunication between the two disciplines.
Orthodontics is not just about straightening teeth—it’s a powerful tool for optimizing restorative dentistry. By incorporating orthodontic principles into my treatment planning, I have improved my ability to restore worn teeth, prepare crowns more conservatively, and enhance implant outcomes. Every patient I see is a potential candidate for orthodontic intervention, not just for esthetics but to ensure my restorative work is built on a solid, functional foundation.
If you’re interested in learning more about integrating orthodontics with restorative dentistry, I encourage you to explore further education opportunities. The Fellowship in Restorative Dentistry at RipeGlobal has been instrumental in shaping my approach, and I believe that any dentist looking to elevate their practice would benefit from a multidisciplinary perspective.
You can also follow me on Instagram @dr_jaclyntoh for more tips and to stay updated on my upcoming masterclasses.