Trångställning

Trångställning, commonly translated as tooth crowding, is a dental malocclusion in which there is insufficient space in one or more dental arches for erupting or positioned teeth. This leads to overlapping, rotated, or displaced teeth and can affect both the aesthetic appearance and oral function. Crowding is among the most frequent malocclusions seen in adolescents and adults.

Causes of trångställning include a mismatch between tooth size and available arch length, genetic factors that influence jaw and tooth size, early loss of primary teeth leading to space loss, late eruption, and irregular eruption paths. Environmental influences and habits can contribute, but the condition is primarily related to space availability within the jaws.

Classification typically describes severity as mild, moderate, or severe, and can be localized (often anterior) or generalized. Distinctions are made between dental crowding, where tooth alignment is off due to space issues, and skeletal crowding, where jaw size limits space.

Diagnosis involves clinical examination, dental impressions or digital scans, photographs, and radiographs. Space analysis or arch length discrepancies are used to assess how much space is available versus required.

Treatment aims to align teeth, improve bite function, and facilitate hygiene. Options range from non-extractive approaches (orthodontic braces or clear aligners, interproximal reduction, and arch expansion) to extraction of teeth to gain space, and, in severe cases, surgical-orthodontic treatment. Early interceptive measures may be taken in children, such as space maintainers or palatal expanders.

Prognosis is generally favorable with modern orthodontics, provided appropriate treatment planning and retention are followed to prevent relapse.