Malocclusion of the Teeth

Written by Darla Burke | Published on August 20, 2012
Medically Reviewed by George Krucik, MD

What is Malocclusion of the Teeth?

Occlusion is a term that is used to refer to the alignment of your teeth. Ideally, your teeth should fit easily within your mouth without any crowding or spacing. In addition, none of your teeth should be rotated or twisted. The teeth of your upper jaw should slightly overlap the teeth of your lower jaw so that the points of your molars fit into the groves of the opposite molar.

Deviations from ideal occlusion are known as malocclusion. If the teeth are misaligned, they will not be able to perform vital functions and may cause health problems. Alignment of upper teeth is needed to prevent the cheeks and lips from being bitten, while alignment of lower teeth is needed to protect the tongue.

Malocclusion of teeth is also known as: crowded teeth, misaligned teeth, crossbite, overbite, underbite, or open bite.

What Causes Malocclusion?

Malocclusions typically inherited, meaning that it is passed down from one generation to the next. Statistics indicate that only 30 to 40 percent of the population has perfectly aligned teeth (Emerich & Wojtaszek-Slominska, 2010).

Although many cases of malocclusion are inherited, there are some conditions or habits that may alter the shape and structure of the jaw. These include:

  • cleft lip and palate
  • the use of a pacifier after the age of three
  • the prolonged use of bottle feeding in early childhood
  • thumb sucking in early childhood
  • injuries that result in the misalignment of the jaw
  • tumors in the mouth or jaw
  • abnormally shaped or impacted teeth
  • poor dental care that results in improperly fitting dental fillings, crowns, or braces

What Are the Symptoms of a Malocclusion?

Depending on the classification of malocclusion, the symptoms of the disorder may be subtle or severe. Typical symptoms of malocclusion include:

  • improper alignment of the teeth
  • alteration in the appearance of the face
  • discomfort when chewing or biting
  • speech problems, including the development of a lisp
  • breathing through the mouth rather than the nose

Diagnosing and Classifying Malocclusions

Malocclusion of teeth is typically diagnosed through routine dental exams. Your dentist will examine your teeth and may perform dental X-rays to determine if your teeth are properly aligned. If malocclusion is detected, it will be classified by its type and severity. There are three different classes of malocclusion:

Class 1

Class 1 malocclusion is diagnosed when the upper teeth overlap the lower teeth. In this type of malocclusion, the bite is normal and the overlap is slight. Class 1 malocclusion is the most common classification for malocclusion.

Class 2

Class 2 malocclusion is diagnosed when a severe overbite is present. This condition, known as retrognathism, means that the upper teeth and jaw significantly overlap the lower jaw and teeth.

Class 3

Class 3 malocclusion is diagnosed when a severe underbite is present. This condition, known as prognathism, means that the lower jaw protrudes, which causes the lower teeth to overlap the upper teeth and jaw.

How Is a Malocclusion of the Teeth Treated?

Most patients with mild malocclusion will not require any treatment. However, if your malocclusion is severe, your dentist may refer you to an orthodontist. Depending on your type of malocclusion, your orthodontist may recommend various treatments, which can include:

  • braces to correct the position of the teeth
  • removal of teeth to correct overcrowding
  • reshaping, bonding, or capping teeth
  • surgery to reshape or shorten the jaw
  • wires or plates to stabilize the jaw bone

How Can Malocclusion Be Prevented?

Because most cases of malocclusion are hereditary, preventing the disorder can be difficult. Parents of young children should limit pacifier and bottle use to help reduce changes in the development of the jaw. Early detection of malocclusion may limit the duration of treatment needed to correct the problem.

What Is the Long-Term Outlook for Patients With Malocclusion of Teeth?

The treatment of malocclusion of teeth in children and adults typically results in correction of the problem. Early treatment in childhood will reduce the duration of treatment and make it less expensive.

Good results for adults can also be achieved. However, treatment for adults will often take longer and will be more expensive. Treatment for the disorder may also result in some complications. These include:

  • tooth decay
  • pain or discomfort
  • irritation of the mouth from the use of appliances, such as braces
  • difficulty chewing or speaking during treatment
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