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Common Orthodontic Treatments


The Common Smile Concerns

Can Invisalign fix an overbite? Can I get braces for crowded teeth? These are the types of questions we hear a lot as a Cary, Raleigh and Durham orthodontist. What you may not know is that your teeth are as unique as your fingerprints! That means smile concerns and treatment plans will vary by patient. However, in general, these are the most common orthodontic issues we treat at VanderWall Orthodontics.



Crowding occurs when there isn’t enough space in the jaw to fit all of the teeth. In an attempt to squeeze into the small area, teeth can twist, overlap or get blocked out of line. Crowded teeth can be due to genetics (i.e., the tooth-to-jaw-size ratio is out of balance) or losing primary teeth too early. Since crowded teeth are harder to properly brush and floss, crowding can increase your risk of tooth decay and gum disease.

For a standard case of crowded teeth, metal braces, clear braces, InBrace® hidden braces, Invisalign®, Invisalign Teen or Clarity™ Aligners could be effective on their own. For a severe case, sometimes, we’ll need to expand the jaw using certain appliances while a patient is still growing. At VanderWall Orthodontics, we only extract teeth as a last resort.


Spacing is when there are gaps between two or more teeth because the teeth can’t fill out all of the space in the jaw. Spacing or gaps between the teeth can be due to genetics, narrow teeth, missing teeth or habits like prolonged thumb sucking. While spacing can make you feel self-conscious about your smile, it can also have a negative impact on the health of your gums and lead to jawbone loss. We can usually close the gaps and straighten the teeth with braces or clear aligners.


A patient is said to have an overbite when the upper front teeth stick out too far in front of the lower teeth. While many people have some degree of an overbite, when the space between the top and bottom teeth is too large, it can make the top teeth more susceptible to injury, lead to jaw pain and cause excessive wear of the enamel.

Dr. VanderWall may treat a mild or moderate overbite with metal braces, clear braces, InBrace behind-the-teeth braces, Invisalign or Clarity Aligners. Sometimes, he’ll also use extras like rubber bands in conjunction with braces or aligners. For a more severe overbite, it might be necessary to use appliances to guide jaw growth or shift the jaw into the correct position along with braces or clear aligner treatment.


An underbite is when the bottom teeth sit in front of the top teeth when the jaw is closed. An underbite can occur when the upper and lower jaw grow at different rates. If not treated, an underbite can lead to uneven wear and problems with chewing and speaking. Diagnosing and treating an underbite early is key and can help patients avoid corrective jaw surgery as an adult.

To fix an underbite, Dr. VanderWall might use special appliances to advance the jaw followed by braces or clear aligners. In adults, while there are cases that can be treated with braces or clear aligners, sometimes, surgical orthodontics is necessary. That’s where corrective jaw surgery is combined with orthodontic treatment.


A crossbite is characterized by some of the bottom teeth sitting in front of some of the top teeth. A crossbite can involve the front teeth (an anterior crossbite) or the back teeth (a posterior crossbite). People have a tendency to shift their jaw to the side to compensate for a crossbite, which may lead to permanent changes in their bone structure. Crossbites can be genetic or caused by trauma, the early loss of baby teeth or certain oral habits.

We’ll often use clear aligners or braces for an anterior crossbite. A posterior crossbite, depending on the severity, could require Dr. VanderWall to expand the jaw with appliances and then use braces or clear aligners to shift the teeth into place.

Open Bite

You’re said to have an open bite if the top and bottom teeth don’t meet at all when you close your jaws. An open bite can make it really difficult to bite and chew and it can cause speech difficulties. Genetics and habits, such as prolonged thumb sucking and tongue thrust, can lead to an open bite.

While, again, how we correct an open bite will depend on how complex the case is, sometimes, braces, Invisalign or Clarity Aligners alone can help the teeth come together correctly. In more severe cases, if caught early, we can use appliances to guide jaw growth followed by braces or clear aligners.

Your Smile Transformation Starts Here!

Find out how we can give you a healthy, confident smile with braces or clear aligners in Durham, Raleigh or Cary, NC.

Book A free consultation

Your Smile Transformation Starts Here!

Find out how we can give you a healthy, confident smile with braces or clear aligners in Durham, Raleigh or Cary, NC.

Book A free consultation