The Day I Covered My Mouth When Smiling Due to Crooked Teeth, Orthodontic Treatment Became the Answer

This article is content written by Dr. Seo Young-joon (29 years of experience) from U&I Adens Dental Clinic, based on clinical experience in implants, prosthetics, and aesthetic orthodontics.

There was a patient who covered their mouth with their hand every time they took a photo because their front teeth were crooked. They couldn't smile brightly in front of colleagues at work and fell into a vicious cycle of only looking at their teeth in the mirror. At first, they thought, "This level should be fine," and left it untreated. However, after 6 months, things changed. Food started getting stuck frequently during meals, and brushing became difficult. Another year passed, and not only the front teeth but also the molars began to have misalignment problems. At this point, after consulting with Dr. Seo Young-joon, they thought, "I'm so glad I started even at this time."

Early signals requiring orthodontic treatment go beyond mere cosmetic concerns. The earlier the detection, the shorter the orthodontic period, and the more complex procedures like future implants or prosthetic treatments can be avoided. Especially after becoming an adult, tooth movement can be slower, so missing the signal can require 2 or more years of long-term treatment.

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The signals that orthodontic treatment is needed become clear in front of a mirror. In this patient's case, their condition when first entering the clinic was as follows:

Two to three front teeth were protruding outward, and from the side, the "jutting forward" appearance was noticeable. Even when the mouth was closed, the tips of the front teeth were slightly exposed, and when smiling, it became more pronounced, making it impossible for them not to be self-conscious. More problematic was the functional aspect. When chewing food, the contact angle between the upper and lower front teeth was incorrect, so they felt awkwardness every time they bit into hard food.

When Dr. Seo Young-joon first made the diagnosis, what he pointed out was not simply a "tooth alignment problem." He explained that if the misaligned state of the teeth continued, irregular forces would be applied to the gums, eventually leading to gum disease. Additionally, there were multiple spaces where food debris wouldn't be properly removed, increasing the risk of cavities.

As a result of neglecting it for a year and a half, concerns emerged that orthodontics alone might not be sufficient. This is because not just the teeth but the jawbone could be affected. Dr. Seo Young-joon advised, "If you start now, 18 to 24 months would be sufficient, but if you delay further, it could take 2 and a half years or longer."

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What was most surprising when the actual orthodontic treatment began was that there were far more observation items than anticipated. Dr. Seo Young-joon's clinical philosophy was not simply "straightening the teeth" but rather "considering the overall mouth shape, facial impression, and chewing function together."

The orthodontic treatment proceeded in the following stages:

Initial Diagnosis and Treatment Plan Establishment — Calculating the current tooth position, jawbone condition, and distance to move through precise 3D scanning. Explaining the differences between clear aligners and traditional bracket orthodontics and deciding on a method reflecting patient preference

Months 1-6 — The period with the fastest tooth movement. Monthly visits to adjust the orthodontic device or replace the orthodontic wire. During this period, the "jutting forward" condition begins to improve gradually

Months 6-12 — The direction of the front teeth stabilizes, and the bite (occlusion between molars) is finely adjusted. The feeling of chewing food gradually becomes more natural

Months 12-18 — Final alignment stage. Precisely adjusting the spacing between each tooth and setting the degree of tooth exposure when smiling to the desired level

After 18 months — Beginning to wear the retention device (retainer) after removal of the orthodontic device. This stage is an important point that determines long-term success

Particularly noteworthy was the 6-month mark. At this point, the patient began to notice that the shape of their mouth was changing when looking in the mirror. They had improved enough that they could smile brightly without needing to cover their mouth with their hand. This was the catalyst that caused psychological change.

Dr. Seo Young-joon explained at this point "why orthodontic treatment goes beyond a simple cosmetic issue." The toothbrush enters cleanly between the aligned teeth, food debris gets stuck much less frequently, and ultimately gum health improves. In fact, at the 12-month gum condition check, the inflammation index returned to normal range.

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The day the orthodontic device was removed, the patient's reaction went beyond simple "satisfaction." It was because they saw their true smile reflected in the mirror for the first time.

Of course, the condition wasn't perfect. This is exactly where Dr. Seo Young-joon emphasized. He explained, "The retention period after orthodontic treatment is complete determines the overall treatment effect." Teeth have the nature of constantly trying to return to their original position once aligned, so wearing a retainer is essential.

This patient wore the retainer all day for the first 3 months, then transitioned to wearing it only at night. At U&I Adens Dental Clinic near Apgujeong Station in Sinsa-dong, Gangnam-gu, Seoul, customized retainers are fabricated for each individual, allowing stable use for a long time without rework.

The most noticeable change after completing the orthodontics was psychological confidence. They could smile brightly in photo sessions at work and at gatherings with friends. More importantly, there was functional improvement. The efficiency of chewing food increased, improving digestion, and brushing became much easier, maintaining gum health.

The dental philosophy that Dr. Seo Young-joon emphasized—"recovering both function and aesthetics together"—was completed here. Not just external appearance was improved, but the overall health and function of the mouth was restored.

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In this patient's case, treatment was completed in 18 months. But what if they had delayed another year? Dr. Seo Young-joon's diagnosis was clear. The longer the initial signal is missed, the longer the orthodontic period increases not linearly but exponentially.

The reasons why orthodontic duration lengthens are as follows:

•Possibility of Jawbone Deformation — When chewing with incorrect occlusion for a long time, the jawbone itself can deform. In this case, orthodontics alone is insufficient and surgical orthodontic procedures may be necessary

•Deterioration of Gum Condition — Bacteria proliferate between irregular teeth, causing chronic gum inflammation. With inflammation present, the speed of tooth movement slows down

•Damage to Tooth Roots — If incorrect occlusion pressure continues to be applied, the roots of some teeth may be resorbed. In this case, complete restoration through orthodontics may not be possible

U&I Adens Dental Clinic, located at 10 Nonhyeon-ro 161-gil, Gangnam-gu, Seoul, places emphasis on precise 3D scanning and occlusion analysis to detect such complications early. For patients who miss early signals, the clinic emphasizes that 2 or more years of extended orthodontics may become unavoidable.

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This patient was in their early 30s. Generally, adolescent orthodontics takes about 12 to 18 months, but adult orthodontics is the 18 to 24-month standard. Dr. Seo Young-joon clearly explained the reasons.

First, the jawbone has already completed growth. In adolescents, the jawbone is still growing, so it responds easily to orthodontic force, but in adults, it does not. Therefore, weaker force must be applied for longer periods.

Second, the remodeling speed of gums and bone is different. When moving teeth, the process of the surrounding bone dissolving and regrowing is slower in adults.

Third, there may be existing dental treatment history. In this patient's case, there were fillings or small prosthetics that needed to be readjusted along with the orthodontics.

Based on Dr. Seo Young-joon's 29 years of experience, the most important thing in adult orthodontics is "not rushing." Patients who don't miss monthly to bimonthly regular visits and faithfully carry out the retainer-wearing stage typically achieve their desired results within 18 months on average.

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"Why do people delay the orthodontics they need?" Dr. Seo Young-joon's answer based on treating many patients is as follows:

First, "normalization" with the thought "this level should be fine." When your own tooth condition persists for decades, your brain learns it as "normal." Therefore, what appears to others as clear malocclusion is perceived by you only as inconvenience.

Second, the time psychology of "2 years is too long." The moment patients hear 18 to 24 months, they think they will live the entire period only with the appearance of wearing orthodontic devices. In reality, however, it's a period where they live normally in daily life while experiencing gradual improvement.

Third, financial burden. The cost of adult orthodontics ranges from 6 to 12 million won depending on region and difficulty. If treatment is started at the early signal stage, it's possible to begin with lower costs, but the more you delay, the more the total cost can more than double as implants or prosthetics must be considered.

Dr. Seo Young-joon reemphasizes the advice he gave to this patient. "The 18 months of investment and treatment costs you make now will allow you to live with a confident smile for the next 20 to 30 years."

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Q1: Does adult orthodontics really take 18 months or longer?

A: It varies depending on the patient's initial condition and goals. In cases like this example where only front tooth alignment is needed, 12 to 15 months is possible, but if the overall bite (upper and lower teeth occlusion) needs to be adjusted, 18 to 24 months is standard. If early signals are missed, 24 months or longer is possible. What's important is not "quick" but "stable" completion.

Q2: Which is faster—clear aligners (Invisalign) or traditional bracket orthodontics?

A: In terms of efficiency alone, fixed bracket orthodontics can be slightly faster. However, patient compliance (wearing the orthodontic device daily) determines the success of clear aligners. This patient chose clear aligners because appearance management was important for their work. Consequently, they completed within the expected timeframe by faithfully wearing them.

Q3: Can the device be removed or take a break during orthodontic treatment?

A: It's impossible. The moment you stop the orthodontic force, teeth have the nature of trying to return to their original position. Even with vacations or special events, the orthodontic device must continue to be worn and you must follow your clinician's instructions. If you stop and then restart, additional time may be required.

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| Item | Early Signal Stage Orthodontics | Neglected, Advanced Condition Orthodontics |
|------|----------------------------------|------------------------------------------|
| Expected Duration | 12-18 months | 20-30+ months |
| Total Treatment Cost | 6-9 million won range | 10-15 million won range (with implants) |
| Tooth Movement Ease | High compliance, fast movement | Slow bone remodeling, complex plan needed |
| Gum Condition | Minimal inflammation, stable | Existing inflammation improvement needed, time-consuming |
| Long-term Stability | High | More strict retainer wear required |
| Psychological Impact | Feel improvement from early stage | Feel change from midway point |

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The difference between this patient when they first entered the clinic and 18 months later is not simply a matter of "tooth alignment." The way they smiled changed, the discomfort during meals disappeared, and most importantly, they gained confidence.

Dr. Seo Young-joon's way of explaining this is clear. "Orthodontic treatment is therapy that recovers both aesthetics and function. The longer early signals are missed, the more exponentially time and cost increase." As this case proves, the moment your front teeth appear even slightly crooked is the moment to make a decision.

A life where you don't need to cover your mouth when smiling, a daily life where you can chew food comfortably—all of this began with an 18-month investment. While many patients regret it, all who have started say, "I'm so glad I did it even at this time."

If you sense early signals that orthodontics is needed, don't delay. Getting a comprehensive evaluation of your jawbone condition, gum health, and occlusion and establishing a customized treatment plan is the first step. U&I Adens Dental Clinic, based on Dr. Seo Young-joon's 29 years of experience, provides treatment that goes beyond simple orthodontics to recover both function and aesthetics together.

For an orthodontic consultation, please contact 02-541-8471.

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