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Can Clear Aligners Fix Severe Crowding? A Deep Dive Case Study

Dr Yasha Shirazi
Can Clear Aligners Fix Severe Crowding? A Deep Dive Case Study

Think your teeth are "too crooked" for aligners? Think again. We explain how IPR, attachments, and digital planning allow us to treat complex crowding cases.

One of the biggest myths in orthodontics is that "clear aligners are only for minor straightening."

Five years ago, that might have been true. Today? It is false. At ProAligners, we routinely treat severe crowding cases that previously would have required metal train-track braces and even tooth extractions.

What is Dental Crowding?

Crowding happens when there is a discrepancy between the size of your jaw and the size of your teeth. Basically, you have too much tooth and not enough bone. The teeth twist, overlap, and jostle for position.

The problem isn't just cosmetic:

  • Overlapping teeth create "plaque traps" that are impossible to floss.
  • This leads to accelerated decay and gum disease in those specific spots.
  • Uneven wear occurs because teeth are banging against each other incorrectly.

The ProAligners "Secret Weapon": IPR (Interproximal Reduction)

Patients often ask: "If my mouth is full, how do you make space without pulling teeth out?"

The answer is IPR. This safe, routine procedure involves polishing away a fraction of a millimetre (usually 0.2mm to 0.5mm) of enamel from the sides of specific teeth.

✨ How IPR Creates Space ✨

1
The Problem: Teeth are jammed together like books on a tight shelf.
2
The Solution: We polish 0.2mm (width of a sheet of paper) from the contact point.
3
The Result: Across 10 teeth, this creates 2-3mm of total space—enough to untwist a crooked incisor!

Does it hurt? No. Enamel has no nerves. It feels like a vibration.

Dr Yasha

Expert Insight: Dr Yasha Shirazi

Clinical Director & Principal Dentist (GDC: 195843)

"Severe crowding is my favourite challenge. Using 'Attachments' (tiny tooth-coloured grips), we can apply rotational force that plastic alone couldn't achieve. Watching a patient who has hidden their smile for 20 years finally grin in a photo is why I do this job."

Arch Expansion: Broadening the Smile

Another way we treat crowding is by widening the arch. Many adults have narrow smiles (where the teeth tip inwards). Aligners are excellent at tipping these teeth outwards into a more upright position.

This does two things:

  1. Creates space to resolve the crowding.
  2. Fills out the "buccal corridors" (the dark spaces in the corners of your mouth when you smile), giving you a wider, more radiant smile.

When is a case TOO complex?

There are limits. If your crowding is caused by skeletal jaw issues, or if a tooth is impacted deep in the bone, we might need a multidisciplinary approach. However, 90% of the "complex" cases we see in consults can be treated with our Ultimate Align Plan (£2,990).

Written by Pro Aligners Team

Medically reviewed by Dr Yasha Shirazi • GDC: 195843