[Health Column] Orthodontics First or Implants First? Key Criteria for Determining Treatment Order

 

Hello, I am Soo-hwan Oh, the Chief Director and Board-certified Orthodontist at Smile D Dental Clinic. 😊

 

When I see patients in the examination room I lost a molar. Should I get an implant first? , I had a consultation for braces and they told me to get braces first, but another dental clinic said I should get implants first. I very often see people who are confused, saying...

 

Since it is your own teeth and the recommended order varies from dentist to dentist, you must have felt at a loss as to what decision to make. In fact, there is no single correct answer to this question: "You must do this first." However, Criteria for determining the order There is definitely.

 

In today's column, for those of you facing orthodontic and implant treatment, I will explain in an easy-to-understand way why opinions may differ among dental clinics and what the criteria are for determining the correct treatment sequence for your teeth.

 

1️⃣ Why does the order of treatment differ from dental clinic to dental clinic?

Both orthodontics and implants address the position of the teeth and chewing forces, that is Representative dental treatments that directly affect 'occlusion' While the answer may seem clear when looking at each treatment in isolation, the order has a decisive impact on the overall treatment outcome when considering both together.

 

 

The reason opinions differ among dental clinics is not that one side is wrong, but rather, Where the main goal of treatment is placed This is often because the approach differs. Some places focus on quickly restoring the empty space, while others prioritize improving overall crowded teeth or protrusions.

 

 

So when you receive counseling, rather than "which one is right" "What the ultimate goal of my teeth is" Organizing it first serves as the starting point for determining the order.

 

2️⃣ Why is it recommended to get braces done first in many cases?

The key point is Whether to move or be fixed It lies in the difference.

 

🔹 Natural teeth are 'movable teeth'

Natural teeth can be freely repositioned by attaching orthodontic appliances, such as by moving them forward or backward or adjusting their angle. This is precisely why orthodontic treatment is possible.

 

🔹 Implants are 'fixed structures'

However, implants placed in the gum bone bond firmly with the bone, so once implanted, they do not move on their own. Fixed structure It becomes this way. Even if orthodontic force is applied, it does not move like natural teeth.

 

 

If implants are placed in the wrong position before the final tooth alignment is accurately determined, when undergoing orthodontic treatment later... Obstacles that block the movement of surrounding teeth This can happen. As a result, the overall difficulty of the treatment may increase significantly, such as making it difficult to secure the ideal space that could have been originally created or causing the chewing height to become awkward.

 

natural teeth	'Mobile teeth' whose position and inclination can be adjusted with an orthodontic device
implants	A 'fixed structure' that integrates with the bone and does not move after implantation
Why the order matters	Implants placed before the final tooth alignment is determined can become an obstacle to subsequent orthodontic treatment.

 

So, if you are scheduled for orthodontic treatment to change your overall tooth alignment, First, determine the final position of the tooth, then plan the implant site. Doing so becomes the general flow.

 

3️⃣ Is orthodontics always the priority? When should implants be done first?

However, it is also dangerous to conclude that "orthodontic treatment must be started unconditionally." Since there is already sufficient space and the alignment of the molars and the occlusion are good, Partial correction that only slightly tidies up the front teeth If this is necessary, the story is different.

 

For these people, if a missing tooth is left untreated for too long, it would actually If the gum bone is absorbed, it may be disadvantageous when implants are placed later. It means that the conditions of the vacant seat are deteriorating while waiting for the correction to finish.

 

 

 

in other words, Location of missing teeth, condition of remaining teeth, amount of gum bone, scope of future orthodontic treatment Depending on your condition, it makes a completely different choice whether to get implants first or orthodontics first.

 

4️⃣ What are the essential questions to check during a consultation?

When different dental clinics recommend a different order, simply asking "Which one should I do first?" will result in conflicting answers. Please check the criteria and questions below.

 

Location of missing tooth	Whether the empty space is on the path where teeth will move due to orthodontics, or is a space unrelated to orthodontics
Condition of the remaining teeth	Whether the molar alignment and occlusion are stable, and whether overall adjustment is needed
amount of alveolar bone	Is there a concern that leaving the space vacant for a long time could worsen the implant conditions due to bone resorption?
Scope of correction	Can the implant placement vary depending on whether it is partial or full front tooth correction?

 

During the consultation, it is safer to ask the following questions and receive a clear explanation.

 

 

If the answers to these two questions are explained based on my oral condition, my anxiety about the order can be largely resolved.

 

 

🗣️ Frequently Asked Questions (FAQ)

Q1. I have already had dental implants placed, but I have been told that orthodontic treatment is absolutely necessary. What should I do?

A1. Since already implanted implants do not move in response to orthodontic forces, there may be limitations during full orthodontic treatment. However, it is not absolutely impossible; it is important to receive an in-depth, precise diagnosis from an orthodontist, as the movement plan for surrounding teeth must be meticulously readjusted based on the position of the existing implants.

 

Q2. I am confused because the recommended order of treatment varies from dental clinic to dental clinic. What should I check?

A2. Opinions may differ as each dental clinic focuses on the primary goal of treatment (e.g., rapid restoration of gaps vs. overall improvement of crowded or protruding teeth). During the consultation, rather than simply asking about the order, it is safer to ask questions such as, "Why is this order more advantageous for my teeth?" or "Will the implant position or space change when I undergo orthodontic treatment later?" to receive a clear explanation.

 

Q3. What problems can arise if a missing tooth is left untreated for a long time?

A3. If a gap remains for a long time, the teeth on either side may tilt into the empty space, or the opposing teeth may rise. Additionally, as the gum bone gradually resorbs, the scope of surgery for future implant or orthodontic treatment may become wider and more complex; therefore, we recommend that you undergo an accurate examination as soon as possible.

 

🎯 Conclusion

Orthodontics and implants are important treatments that determine the lifelong health and aesthetics of your teeth. Rather than concluding that you must unconditionally perform one or the other based solely on fragmentary information found online, Getting an accurate diagnosis of my oral condition and final target tooth location, and carefully formulating a plan This is more important than anything else.

 

 

As the sequence of treatment can significantly alter the overall difficulty and outcome, we encourage you to consult thoroughly with medical professionals possessing extensive clinical experience to find the safest and wisest treatment path for you. 🦷

 

The medical content of this column was written with reference to orthodontic and clinical guidelines.

 

 

👨‍⚕️ Chief Director Oh Su-hwan (Smile D Dental Clinic)

Graduated from Yonsei University College of Dentistry

Major in Orthodontics, Yonsei University Graduate School of Dentistry

Ministry of Health and Welfare certified orthodontist

Regular Member of the Korean Association of Orthodontists · Certified Orthodontist

Completed internship and residency in Orthodontics at Ewha Womans University Mokdong Hospital

International member of the American Association of Orthodontists (AAO)

International member of the World Federation of Correctional Organizations (WFO)

Regular member of the Korean Academy of Aesthetic Dentistry