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What is Malocclusion?

Medically Reviewed by Melinda Ratini, DO, MS on June 03, 2021

Malocclusion is a bite that doesn’t align properly from front to back. It's often characterized as having crooked teeth or a poor bite. Normally, your front teeth align just in front of your lower teeth. The teeth down each side of your mouth also align for an even bite. But very few people have a perfect bite, even with help from braces and other orthodontic treatment.

Understanding Malocclusion

Malocclusion isn’t usually bad for your health and is considered a cosmetic problem. You may not like the appearance of your teeth if they’re crooked, even if it doesn’t cause you harm. 

But if your teeth are overly crowded, without space between the surfaces, you may be more likely to experience tooth decay or tooth loss. In severe cases, malocclusion negatively impacts your ability to eat or speak.

Malocclusion may be characterized by having a/an:

  • Overbite — Your top front teeth stick out significantly past your lower teeth. 
  • Underbite — Your lower teeth stick out over your upper teeth.
  • Open bite — Your front teeth don’t meet when you close your jaw as far as you can. ‌
  • Crossbite — Your top teeth fit behind your bottom teeth. 

Causes of Malocclusion

The most common cause of malocclusion is a problem with the shape or size of your jaws or teeth. You may have too much room or too little room for your teeth on the top or bottom. This leads to extra space around your teeth or crowding from a lack of space. 

‌If you sucked your thumb or used a pacifier as an infant or toddler, these may have contributed to malocclusion. Or lost teeth may leave more space in your mouth for remaining teeth to move around.

Health Risks of Malocclusion

Malocclusion in children poses some health risks that may need to be addressed, including:

  • Difficulty eating or speaking
  • Grinding teeth
  • Losing baby teeth too soon or too late
  • Breathing through the mouth instead of the nose
  • Tooth decay
  • Gum disease‌
  • Jaw joint pain

Diagnosing Malocclusion

Your dentist monitors malocclusion during regular dental visits. Beginning at age two, your child should see a dentist twice per year. Dentists can then address problems early before they progress too far.

Your dentist may refer you to an orthodontist for further examination. The American Association of Orthodontists recommends all children get checked by an orthodontist before age seven.  

During an exam, your orthodontist will:

  • Ask questions about medical and dental history
  • Check your mouth and teeth
  • Take x-rays of your teeth and jaw‌
  • Create a mold of your teeth

Treating Malocclusion

Orthodontic treatment, like braces, is used to correct malocclusion concerns. You’ll have to see an orthodontist who specializes in alignment techniques to move your teeth safely and effectively. Orthodontic treatment often includes:

  • Braces or other aligners
  • Removing teeth in the case of crowding
  • Surgery to correct severe jaw alignment concerns‌
  • Use of retainers following treatment to maintain your new tooth alignment

Braces may be pieces of metal bonded to your teeth with a wire. Your orthodontist will regularly adjust them to move your teeth into the desired position. Braces are usually fixed to the front of your teeth, although they may also be placed on the back of your teeth if you prefer they aren’t easily seen.

You also have the option to use clear aligners. You can take these in and out as needed during your treatment period. Your orthodontist creates a series of clear aligner trays that move your teeth approximately .3 millimeters per week until you reach the desired results.

‌No matter which option you choose, expect to wear the treatment for two to three years. Afterward, you’ll have retainers that you wear at night to maintain the results achieved through orthodontic care.

Maintaining Dental Health

Whether you suffer from malocclusion or not, proper dental care is important for your dental health. Orthodontic treatment like braces and retainers leave you at a greater risk for dental problems because they create small spaces that food particles can get trapped in. You need to be persistent in cleaning your teeth regularly:

  • Brush your teeth twice a day
  • Make sure you brush around all of your teeth from different angles, using gentle pressure to avoid damage to your teeth
  • Use dental floss to clean between teeth and gums
  • Don’t skip any spaces, no matter how small. Bacteria are more prone to build up in small spaces that aren’t easily reached by brushing and flossing
  • Use a water flosser if traditional floss isn’t effective for you
  • Avoid hard foods and seeds that may get stuck in your teeth‌
  • Continue with regular dental cleanings to monitor the growth of plaque and bacteria

Make sure you contact your orthodontist immediately if you think something is wrong with your braces or retainers. If any of your hardware feels too tight, loose, or gets damaged, this may lead to permanent damage to your teeth.

WebMD Medical Reference

Sources

SOURCES:

American Association of Orthodontists: “Taking Care of Retainers.”

Merck Manual: “Malocclusion.”

National Institute on Aging: “Taking Care of Your Teeth and Mouth.”

Stanford Children’s Health: “Malocclusion in Children.”

University of Michigan Medicine: “Malocclusion and Orthodontics.”

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