FOundation first, teeth second
What is the "Foundation"
The "foundations" are the Jaw Bones. These bones support the teeth and without a proper foundation, crowded teeth will ALWAYS be a problem but more than that, this likely means there is a developmental restriction in your (or your child's) upper airway.
The Airway Dentists address the foundation first so that the width of the jaw bones is maximized resulting a better airway and straighter teeth.
Why doesn't everyone do this? Great question! Orthodontic training has not changed in decades...
Teeth Second?
Dentist and teeth go together like peanut butter and jelly, right? Yes, they do but we are not simple molar mechanics! With a proper Foundation, the teeth will follow. When the teeth follow we have the right amount of space to get the teeth to fit in a beautiful and health way so that they have the best chance to last a lifetime!
Luckily getting the teeth right in a health and stabile foundation is simple. This is where most orthodontic treatment begins and is confined to the foundation they begin in. This is how we get relapse, and limited success.
most orthodontic treatment fails to move the back teeth!
Talk about LAZY!
The vast majority of orthodontics in America is being done wrong. Tens of thousands of patients are paying for "Comprehensive Orthodontics" (the actual American Dental Association treatment code, D8090) and what they get is a really great treatment for just the front 8 teeth.
Why? Because moving the back teeth is hard, requires training.
Metal Braces = The Financial Handcuffs of Dentistry
As a young dentist I remember hearing old dentist says that we shouldn't use the "plastic stuff" (clear aligners) because the patient might not finish paying you. Implying that the patient must pay in full before you say treatment is complete and the metal brackets are removed.
Now this represents a very small minority within dentistry but it just the tip of the iceberg of why wire braces are usually the wrong choice.
Clear aligners have progressive load on the teeth making them more comfortable and dental hygiene is much easier resulting in a significantly lower chance of getting hidden cavities from the wire braces.