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The Challenge: A Deep Bite and Structural Crowding
The patient first attended our Dublin practice as a teenager, accompanied by her mother. A comprehensive specialist assessment by Orthodontist Claire O’Sullivan revealed several structural issues:
- Bite Misalignment: A pronounced Class II jaw relationship with a significant deep bite.
- Inwardly Tipped Teeth: Retroclined upper and lower incisors that restricted the natural function of her bite.
- Unerupted Wisdom Teeth: Early panoramic X-rays (OPGs) indicated that all four wisdom teeth were developing but lacked the structural room to erupt normally.
The Treatment Programme: Orthodontics & Oral Surgery
Our team mapped out a comprehensive, non-extraction treatment programme designed to work alongside the patient’s natural growth.
1. Phase One: Twin Block Functional Therapy
We began by fitting custom Twin Block appliances to gently guide the lower jaw forward and expand the dental arches. Our clinical team regularly adjusted the appliances to eliminate initial localized rubbing and maximize dental expansion before moving to the next stage.
2. Phase Two: Fixed Braces Alignment
Following successful jaw expansion, fixed braces were bonded to both the upper and lower arches to align individual teeth and close the patient’s midline gaps. Despite occasional bracket breakages from biting into hard foods, our orthodontic therapists quickly rebonded the appliances to keep the treatment on track. The braces were beautifully de-bond ed in May 2024.
3. Proactive Wisdom Teeth Removal
To prevent future crowding, our specialist oral surgeon, Dr Deepak Thomas, monitored the patient’s wisdom teeth post-orthodontics. In early 2025, all four wisdom teeth were successfully removed under general anaesthetic at Kingsbridge. A one-month post-operative check confirmed superb healing with zero nerve complications or numbness.
The Real-World Lesson: Managing Retainer Relapse
Retainers are crucial to keeping teeth in their new positions. In early 2026, after the patient skipped wearing her retainers for a few nights, a minor movement (relapse) occurred in her upper front tooth.
Our team acted immediately. Dr Claire O’Sullivan reviewed the occlusion and adjusted the retention strategy, transitioning the patient to high-durability, custom-moulded upper and lower Essix retainers to firmly stabilise her alignment and protect her smile from further movement.
Current Status: A Healthy, Stable Smile
In May 2026, the patient attended her routine dental check-up with Dr Emmet Ryan. The clinical exam and updated X-rays confirmed a completely clean bill of health: excellent oral hygiene, minimal plaque, and absolutely no dental decay. She has now been discharged to a standard 12-month routine exam and a 6-month scale and polish schedule.
- The Specialist Advantage: From guiding jaw growth in a teenager to coordinating complex wisdom teeth surgery and managing real-world retainer compliance, our team provides an uncompromised standard of continuous care.
Protect and Perfect Your Smile
Whether your child needs early jaw guidance or you want to discuss options for maintaining your straight teeth, our expert Dublin team is here to support you at every stage.
