Malocclusion

Dentists diagnose patients with malocclusion when their bite is improperly aligned. This can happen for a variety of reasons, including:

• Teeth that are too large for the jaw
• A jaw that is too small for the teeth
• A chronic thumb-sucking habit
• Living with a missing tooth
• Genetic conditions
• Traumatic mouth injury
• Chronic teeth grinding (bruxism)

These conditions cause malocclusions using different mechanisms. Crowding or tooth gaps often result from a jaw that is too small or large for the teeth. In other cases, toddlers who suck their thumbs for too long cause their palate structure to narrow, leading to a shorter tooth arch that is prone to crowding later in life. In patients who have been living with missing teeth for a while, teeth often move into unhealthy positions to fill the gaps, causing malocclusion.

Malocclusions come in three classes, defined by how the structure of the bite is changed by the misalignment. In Class 1 malocclusions, the upper teeth protrude slightly in front of the lower. In Class 2 malocclusions, the upper teeth protrude severely in front of the lower. In Class 3 malocclusions, the lower teeth overlap the upper teeth.

The symptoms of malocclusion depend on the type and severity of your case, but they commonly include:

• Biting and chewing difficulties
• Speech impediments
• Open bite or other bite problems
• Mouth breathing

Malocclusions are not life-threatening, but they can progress in severity when left untreated. Biting difficulties can lead to an imbalanced load on your muscles and tendons, eventually causing chronic jaw pain and TMJ (temporomandibular joint) disorders. In many cases, teeth wear faster due to malocclusions, leading to weak enamel and, in severe cases, tooth cracking or tooth loss.

As a result of this progression, malocclusions are easiest to treat when diagnosed early. The treatment for malocclusion depends on the class and specific problem, but dentists typically offer these options:

• Braces: Braces are the frontline line treatment for most malocclusions as they gently loosen the ligaments that hold teeth in unhealthy positions and reshape the bone structure to create a healthier shape. Options include metal, ceramic, lingual, and self-ligating.
• Invisalign: In minor cases, clear aligners such as Invisalign may be used instead of braces. For some patients, a few months is all they need for clear aligners to realign their bite.
• Surgery: In more extreme cases, dentists may recommend tooth extraction to make room in your arch to heal a malocclusion. Jaw surgery may also be indicated in cases where a genetic or accidental condition has caused the structural issue.