Malocclusion

What is malocclusion?

Malocclusion means having a misaligned bite. When you have malocclusion, your upper and lower teeth don’t fit together properly when you close your mouth. It might happen because you have crowded or crooked teeth. Or it could happen because your upper and lower jaws don’t align the way they should.

Most cases of malocclusion are hereditary. That means you’re more likely to have misaligned teeth if your biological parents, grandparents or siblings also have misaligned teeth. But other factors, like tooth loss or dental trauma, can cause it too.

Untreated malocclusion can be harmful. It causes several health concerns that can worsen with age, like tooth decay and gum disease. It may also affect how you chew or speak. Malocclusion can also impact your mental health. Research shows that some people may avoid social situations and relationships because they feel self-conscious about their oral health and appearance.

Types of malocclusion

You might hear healthcare providers use these terms when describing different types of malocclusion:

• Crossbite: Your upper teeth fit inside your lower teeth when you close your mouth.
• Open bite: Your upper and lower front teeth don’t touch when you close your mouth.
• Overbite: A deep vertical bite. It happens when your upper teeth overlap your lower teeth more than they should.
• Overjet: Your upper front teeth stick out further than they should. Some people call this “buck teeth.”
• Underbite: Your lower front teeth extend beyond your upper front teeth.

How common is malocclusion?

Malocclusion is a common dental issue affecting around 56% of people worldwide. While up to 93% of children and adolescents have some degree of malocclusion, not all these cases require treatment. But if malocclusion interferes with your oral health or function, you should ask your dentist about orthodontic treatment.

What are the symptoms of malocclusion?

Malocclusion symptoms may include:

• Cheek biting.
• Difficulty biting or chewing.
• Lisping or other speech issues.
• Misaligned teeth.
• Mouth breathing.

What causes malocclusion?

Sometimes, malocclusion happens if your teeth are too large (or too crowded) for your mouth. But it can also happen if your upper and lower jaws don’t align. Many things can cause this, including:

• Genetics.
• Ill-fitting crowns, bridges or other dental restorations.
• Impacted teeth.
• Prolonged thumb sucking or pacifier use during childhood.
• Teeth grinding (bruxism).
• Tooth loss.
• TMJ disorders.
• Tumors affecting your jaw or mouth.

What are the complications of malocclusion?

Untreated malocclusion can lead to conditions like:

• Gum recession.
• Injury to your gums.
• Jaw pain.
• Malnutrition (due to chewing issues).
• Sleep apnea or other sleep disorders.
• Tooth erosion.

How is malocclusion diagnosed?

Dentists can diagnose malocclusion during regular dental checkups. They might take:

• Dental impressions to create study models of your mouth.
• Dental X-rays to look for decay or check the bone levels around your teeth.
• Photographs of your teeth to examine the way they fit together.

If you have malocclusion, your dentist might refer you to an orthodontist (a specialist who focuses on aligning your bite). Some general dentists offer braces, but severe cases of malocclusion require a specialist.

Classification systems

Healthcare providers use classification systems to diagnose malocclusions. One example is the Ackerman and Profitt classification system. It describes malocclusion types based on your jaw position and/or how your upper and lower teeth relate to each other:

How is malocclusion treated?

Treatment for malocclusion may include:

• Braces to gently bring your teeth into alignment.
• Clear braces (aligners) to gradually move your teeth into their proper positions.
• Jaw surgery to correct issues you inherited or fix jaw fractures that didn’t heal properly.
• Orthodontic headgear to encourage jaw movement.
• Restorative dentistry to repair missing or damaged teeth.
• Tooth extractions to ease overcrowding and make more room in your jaw.

Can malocclusion be prevented?

Many malocclusions are hereditary, so you can’t prevent them. But environmental factors (like missing teeth) can also contribute to dental malocclusion. Here are some things you can do to reduce your risk:

• Practice good oral hygiene.
• Replace any missing teeth with dental implants or dental bridges.
• Visit your dentist for regular cleanings and exams.

To reduce your child’s risk of malocclusion, discourage them from thumb-sucking or using a pacifier past age 4. These things can lead to dental issues over time.

What can I expect if I have dental malocclusion?

Treating malocclusion takes time. It doesn’t happen overnight. The length of treatment varies depending on the:

• Amount of room available in your mouth.
• Overall health of your teeth, gums and jawbone.
• Severity of dental malocclusion.

On average, it takes about two years to complete malocclusion treatment. For some people, it takes longer. Others may only need braces for a few months.

When should I see my healthcare provider?

You should tell your dentist if you have any concerns about your teeth, especially if you have difficulty biting or chewing.

If you already wear an orthodontic appliance, let your provider know if it breaks or becomes damaged. They’ll need to fix it as soon as possible. Broken orthodontic appliances can slow your treatment.

What questions should I ask my doctor?

If you have misaligned teeth, here are some questions you might want to ask your dentist:

• What type of malocclusion do I have?
• What are my treatment options?
• Will I need oral surgery? If so, will I need it before, during or after orthodontic treatment?
• How long will my treatment take?