In this instalment, Eon Engelbrecht asks Dr Clifford Yudelman why adult teeth tend to drift over time, what everyday factors contribute to this phenomenon, and how listeners can prevent unwanted movement.

(01:13 – 01:21) So Dr Yudelman, what exactly do we mean when we say that my teeth are shifting or going skew and why should our listeners care about it?

Teeth shifting refers to the gradual movement of one or more teeth from their original aligned position, which can be likened to books leaning on a shelf as the structure settles. Although it may appear purely cosmetic at first, early drifting can indicate changes in bite function or gum health that, if ignored, often lead to more extensive and costly treatments later.

(02:28 – 02:35) And doctor, is it genuinely normal for teeth to move as we get older and what’s happening in the mouth to cause this change?

Yes, some degree of drift is normal: adult bone continually remodels through resorption and deposition, and the periodontal ligament responds to micro-strains from chewing forces and lip-tongue pressures. After about age 30, bone formation can lag behind, and gingival tissues may recede, reducing support and allowing teeth to tip or rotate in response to these natural forces.

(04:16 – 04:29) That’s very interesting and how big a role do parafunctional habits like grinding or clenching play in the tooth movements? Can they really make everything drift?

Parafunctional forces such as bruxism or clenching can generate hundreds of pounds of pressure, stressing the periodontal ligament and causing repeated inflammatory remodelling that pushes teeth out of alignment. Uneven enamel wear or fractured cusps from grinding also creates imbalanced bite contacts, which further accelerates tipping, rotation and bone loss in specific areas.

(05:44 – 05:58) And when we look beyond parafunctional habits, doctor, are there any other everyday factors or anatomical issues like wisdom teeth or orthodontic history that contribute to tooth shifting as well?

Apart from grinding, inadequate retention following past orthodontic treatment is a major contributor: if retainers are not worn, teeth tend to relapse to their original positions. Wisdom-tooth pressure is often overstated—impacted or über-buried wisdom teeth rarely push other teeth—but minor trauma, tooth loss, new crowns with high bites and new oral habits (for example, chewing on pens or nail-biting) can each trigger unwanted movement.

(10:26 – 10:42) Dr Yudelman, now let’s say someone notices their front teeth overlapping a bit or the bite line is shifting a bit. What are the real world consequences of leaving drifting untreated? Will they just drift out of your mouth or what’s going to happen?

Drifting front teeth won’t fall out of your mouth, but they can create psychological and functional issues: even mild overlapping affects your smile confidence, leads to uneven enamel wear, chipping, and may strain the TMJ. Untreated drifting also makes oral hygiene more challenging, increases the risk of gum disease and can significantly extend—and raise the cost of—future orthodontic intervention.

(13:06 – 13:18) Retainers, let’s talk about retainers. How do they work and at what point should someone consider them? Are we talking about full-time wear forever or are there more flexible options, Dr Yudelman?

Retainers keep teeth in place by stabilising the periodontal ligament after orthodontic treatment: nowadays, fixed bonded wires behind the lower front teeth or clear vacuum-formed (Vivera) retainers are common. Initially you wear them full time to allow bone and ligament to adapt, then transition to overnight wear plus a couple of hours in the morning and evening, before settling on nightly use indefinitely for life.

(15:23 – 15:36) And what about Invisalign? How can clear aligners fix these minor shifts without full orthodontics? And are there age or bone density limitations?

Each Invisalign tray is designed to move teeth by about 0.25 mm per stage, so a series of known forces gradually returns shifted teeth to their ideal positions. It is best suited to adults with mild to moderate relapse—single-tooth rotations, slight crowding or small midline deviations—and, while low bone density (osteopenia or osteoporosis) may require slower movement, most adults can be treated safely as long as they wear aligners for 20–22 hours a day.

(18:36 – 18:45) Are there non-orthodontic preventative measures beyond retainers that our listeners can adopt if they’re worried about future drifting?

Yes: a custom-fitted night guard protects against bruxism-related microtrauma, preventing grinding forces from shifting teeth. Optimal oral hygiene—daily flossing or interdental brushing, six-monthly professional cleanings—maintains firm, healthy gums that anchor teeth more securely, while avoiding harmful habits (chewing ice, nail-biting or using teeth as tools) helps reduce unwanted movement.

(20:52 – 21:01) Okay, and doctor, are there situations where shifting teeth hinted something a bit more serious going on in your mouth?

Occasionally, unexplained drifting or associated pain may indicate underlying pathology—such as abscesses, cysts or jaw-bone lesions—that warrant further investigation with panoramic or CBCT imaging. If drifting comes with pain, swelling or unusual bone-loss patterns, it may signal infections or more sinister lesions like tumours, especially in younger individuals.

(23:17 – 23:30) And then finally, Dr Yudelman, if a listener wants to be proactive right now, what are three simple steps they can take this week to protect their smile from unwanted shifting?

First, schedule a retainer check—even if your teeth feel stable—to ensure existing retainers or bonded wires still fit correctly and replace any worn-out retainer immediately. Second, identify and minimise parafunctional habits (bruxism, clenching, nail-biting) and consider a custom night guard if needed. Third, upgrade oral hygiene by adding interdental brushes and flossing tight areas to reduce gum inflammation, since healthy bone and gum tissues resist unwanted movement better.

Further listening:

• Parafunctional habits: Nail Biting – https://optismile.co.za/blog/parafunctional-habits-nail-biting/ optismile.co.za

• Parafunctional habits: Cheek & Lip Biting – https://optismile.co.za/blog/cheek-lip-biting-dental-risks/ optismile.co.za

• Grinding Through It – Understanding Bruxism and TMJ Disorders (Episode 41) – https://optismile.co.za/blog/understanding-bruxism-tmj/ optismile.co.zaoptismile.co.za

• Relief and Recovery: Managing Bruxism and TMJ Disorder (Episode 42) – https://optismile.co.za/blog/relief-and-recovery-managing-bruxism-and-tmj-disorder/ optismile.co.za

• Invisalign vs Traditional Braces – https://optismile.co.za/blog/invisalign-vs-traditional-braces/ optismile.co.za

• Gum Disease – Early Signs, Professional Care, and Recovery – https://optismile.co.za/blog/gum-disease-early-signs-professional-care-and-recovery/ optismile.co.za

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Disclaimer: The content provided in this podcast, "Save Your Money Save Your Teeth" on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.