Malocclusion is a misalignment issue, causing poor positioning of the teeth when the jaws are closed. A normal occlusion (bite) is when the jaw bones are in correct position in relation to the teeth. Meaning, your upper and lower molar relationship is aligned and the upper teeth slightly overlap the lower teeth when the jaw is closed. When this is not the case, it affects one’s ability to perform necessary functions such as chewing and speaking.
Malocclusion can refer to a number of different problems including:
- Crowding: Occurs when there is too little room for the teeth, causing what many refer to as crooked teeth.
- Spacing: Occurs when there is too much room for teeth. Allowing teeth to grow or drift out of place, causing gaps between teeth.
- Overbite: Occurs when the upper front teeth reach too far down, covering the lower teeth.
- Underbite: Occurs when the lower teeth protrude farther forward than the upper teeth.
- Open Bite: Occurs when the upper and lower teeth do not overlap, causing an open space between.
- Crossbite: Occurs when an upper tooth or teeth it into the wrong side of the lower teeth.
Typically, malocclusion problems are inherited, meaning there is no way to prevent the cause. However, there are some factors and conditions that can alter the shape or position of the jaw, resulting in malocclusion.
- Cleft lip and/or palate
- Injuries affecting the alignment of the jaw(s)
- Abnormally shaped or impacted teeth
- Thumb sucking in early childhood
- Use of pacifier or bottle after the age of 3
Although for most cases you cannot prevent malocclusion, avoiding or controlling some of habits listed above can prevent the severity of the issue.
The symptoms of these conditions can vary depending on the type of malocclusion. Some symptoms can be more severe than others. The following are indications of the malocclusion problems listed above.
- Difficulty or discomfort when chewing and/or biting
- Common biting or lips and cheeks
- Altered appearance of the face
- Mouth breathing habit
- Speech problems
Diagnosing & Treatment:
Typically, a general dentist is the first to determine if a patient has misalignment issues. The dentist will pull the patient’s cheeks outward, and ask for them to bite down. Allowing the dentist to see the positioning of one’s teeth when their jaws are closed. Any issues addressed will then be referred to an orthodontist for further diagnosis. Diagnostic procedures such as head, teeth and skull x-rays, as well as orthodontic records will help diagnose the malocclusion.
When there is a misalignment of the teeth and jaw, malocclusion is diagnosed. Malocclusion is then categorized into 3 classes depending on the type and severity of the misalignment in one’s mouth.
Class 1: This is the most common classification of malocclusion. Class 1 occurs when the upper teeth slightly overlap the lower teeth, also known as a “normal bite”. Although the molar and jaw relationship is normal, regular orthodontic problems such as crowding and spacing are common in Class 1 cases.
Class 2: This classification exists when there is a severe overbite. This occurs when the upper teeth and/or jaw to significantly overlap the lower teeth.
Class 3: This misalignment arrangement creates the lower jaw and/or front teeth to protrude. Causing the lower teeth to significantly overlap the upper teeth.
Once the classification of the malocclusion is determined, a treatment plan is organized specifically to correct the bite and any other orthodontic needs. The following, are common treatment options for malocclusion.
Fixed appliances: In most cases, braces are needed to correct misalignment. Brackets are secured directly to the front of each tooth. Ligatures attach an archwire in place along the brackets. This arch wire creates a constant force, which guides the teeth to their desired position. Elastics are sometimes used to throughout orthodontic treatment to correct the relationship between the upper and lower arches in a patient’s mouth.
Extraction: This procedure is common in orthodontic cases where there is severe crowding. Removing one or more teeth can create space in the patient’s mouth, allowing more room for teeth to shift into proper alignment.
Orthognathic Surgery: Orthognathic surgery is a surgical procedure that corrects jaw deformities by adjusting the position or length of the jaw. Once the teeth are set at their ideal position, an oral surgeon will move the bone of one or both jaws into the proper position in relation to the surrounding anatomy. In majority of cases, orthognathic surgery is performed in conjunction with braces.
Growth Modification: Orthodontists recommend that all children should have an orthodontic examination no later than age of 7. An experienced orthodontist can easily determine if your child has any developmental issues and whether he or she needs any intervention. If an issue such as crowding, overbite, underbite or loss of teeth due to accidents is detected at an early stage, with the implementation of orthodontic treatment, problems can be managed with the appropriate and natural course of therapy. The orthodontist will carefully monitor your child’s dental development as the treatment continues. In most cases the orthodontist can achieve results that are not possible once the facial structure and the jaw bones have finished growing.