What Is Malocclusion?
A malocclusion is a term that is used when the jaw does not close properly. It comes from the Latin word mal, which means bad, and the word occlusion, which is simply the term dentist use for the jaw closing. They’re basically three types of malocclusion- gaps/crowding, overbite, and underbite.
These types of problems are becoming more and more common. It is estimated that nearly 80% of the population has some form of malocclusion, although the vast majority do not need dental treatment for them. It is highly recommended that you visit your dentist if you think you have an issue with your teeth or your jaw. If you let these issues go on too long, they can become serious problems.
Malocclusion can occur at any point in life. Most often, it occurs in children. But, as adults, we can get malocclusion, too. That’s because our facial bones including our eye sockets, nose and upper jaw are still growing, and will grow our entire lives. The jaw bone and tissue of the gums are continuously replaced as they grow. Although the teeth don’t grow, the roots and the nerves will continue to grow and support the teeth.
If there’s a problem with the growth, the teeth can move. Regular visits to your dentist will help identify a problem before it becomes serious. We’ll be covering ways to avoid malocclusion and ways to treat it. If it’s caught early enough, simple, low-cost fixes can be used.
Types of Malocclusion
Class 1 Malocclusion with Gaps
This is the most common type of malocclusion. The gap is simply a space between two teeth (Diastema) where there should not be one. The most common gap occurs in children and it is a simple gap between the two front teeth. Often times, this gap will close on its own.
Gaps can also occur when teeth drift in the jaw. A gap can come and go or it can be permanent. In adults, gaps are slower to form and slower to go away.
When dentist feel there was a problem with a gap between your teeth, they will recommend treatment. The reason for this is that food particles can become stuck in the gap, and it can lead to dental decay. It can also cause problems later in life with other teeth, especially if the gap is caused by a more serious jaw issue.
Class 1 Malocclusion with Crowding
Crowding occurs when there is not enough room in the mouth for all the teeth. It can cause to teeth to crush painfully against each other, or more commonly, two teeth become overlapped. We often see problems with crowding occur when the teeth are pushed outwards towards the lips or inwards towards the tongue.
There are two points in our lives were crowding commonly becomes an issue: as children when adult teeth come in and late puberty when wisdom teeth come in.
With regular visits to the dentist, you can avoid many of the crowding issues. However, many people do not visit the dentist regularly, especially in late teenage years and early adult years.
When overcrowding occurs, it can lead to serious dental problems. Most often are flossing and brushing issues that can leave plaque and food particles stuck between the teeth. Dental decay occurs more often when teeth are crowded.
If crowding becomes more serious, it can be a painful issue. The teeth are physically pushing against each other and their roots can become entangled.
In severe cases, the crowd and can actually cause bite problems and chewing problems.
Class 2 Malocclusion – Overbite
An overbite is an occlusion where are the jaw does not close properly. The upper jaw extends beyond the bottom jaw, causing the top teeth to overlap the bottom teeth. It can range from a severe displacement, where speech, chewing, and even breathing can become problem, to a very minor offset that often do not require any dental treatment.
Overbite Causes
There are basically three types of causes for an overbite: the first one is genetics, the second one is caused by a bad habit, like mouth breathing or sucking the thumb, and the final one is caused by the teeth not growing in properly. Dentist feel that fixing a bad habit and the teeth not growing in properly are the easiest fixes. Genetics can cause more of an issue.
Most common causes of overbite are sucking the thumb and sucking a pacifier. It is one of the reasons why doctors recommend that children break the habit as quickly as possible.
Dentist typically see people with overbites that are caused by the lower jaw being set too far back. In early dentistry, devices were used to pull the upper jaw back, but many dentist found that it only caused more problems and truly did not fix the overbite. As time went on, they begin using braces and other devices to pull the lower jaw forward, rather than the upper jaw back. It resulted in a more symmetrical smile and less health problems later in life.
Overbite Problems
There are many problems when it comes to having an overbite. One of the most common ones is jaw pain. Because the jaw is set further back in the mouth, the TMJ joint does not work efficiently and causes pain.
This can also lead to another issue, grinding teeth (Bruxism). When the lower jaw is set for their back, the molars contact each other more often. When combined with TMJ joint pain, grinding often happens. It happens more often at night, when people are sleeping and not paying attention. This can further irritate the TMJ joint and cause further pain, causing the vicious cycle.
And overbite might also cause sleep apnea. Because the jaw is misaligned, it can compress the windpipe and cause breathing difficulties. This can lead to the apnea and for their breathing problems.
More rare side effects can include gum problems and slurred speech.
Severe Overbite
Despite being the problem the majority of people have when it comes to malocclusion, it is not often addressed because it is not severe. Dentist consider a 1 millimeter – 4 millimeter overbite to be a non-issue. Overbite from 4 millimeters to 11 millimeter are considered moderate and are often treated with braces around the age of 10. Severe overbites may require surgery and are often 11 millimeters or more.
Severe overbites can cause many health issues and often cause speech and chewing problems. They may cause breathing problems and severe pain. Sometimes, surgery can correct the issue in a very young child. But, most often require several years of braces.
Class 3 Malocclusion – Underbite
An underbite is an occlusion where are the jaw does not close properly. The lower jaw extends beyond the upper jaw, causing the bottom teeth to overlap the top teeth. It is often a severe displacement, where speech, chewing, and even breathing problems. It occurs more often in males than in females.
It is often characterized by a protruding jaw. It has a very classic look, almost as if the person is unhappy most of the time.
Most dentists do not consider an underbite an issue that can be ignored. It is recommended that an underbite is treated as soon as possible, preferably before a child enters grade school.
It was often treated by surgery, but today we have many other options that include braces, retainers and exercises back and fix the problem.
Underbite Causes
As with an overbite, an underbite can be caused by hereditary issues, bad habits, and the way the teeth form. Again, fixing bad habits and the way the teeth form easier fixes for underbite. Hereditary issues often include jaw misalignment and malformation, which can require more extensive treatments to truly fix the problem.
Some of the most common causes of underbite are sucking on a thumb or pacifier and mouth breathing.
Underbite Problems
Underbites cause more problems than overbite. There is a greater chance of chewing problems and speech problems with an underbite. But, by and large, people are more often concerned with the look of an underbite. With its distinctive look, people feel they are not looking their best until the problem is fixed.
Grinding teeth and jaw pain are also very common with an underbite.
Severe Underbite
Generally, a severe underbite is corrected during infancy or before the child enters grade school. With a severe underbite, chewing is extremely difficult. The child has severe speech impediments and can often have breathing problems. Fortunately, a minor surgery can often fix this issue before it becomes a problem, where is little as 20 years ago it was not fixed at all.
Class 4 Malocclusion
There are only 3 classes of malocclusions in people. The 4th class is used in veterinary medicine and it defines the misalignment of the jaw side to side. While not officially yet, a few dentists are using this designation, because the problem is being found in people. They are unsure where the problem is coming from.
How To Recognize Malocclusion
Except for an overbite, most malocclusion symptoms are easy recognize. They have obvious signs and looks.
Malocclusion Symptoms
A gap is easily recognized, as is crooked and crowded teeth. Anytime you see an open space or two teeth overlapping, you know you have a Class 1 malocclusion. A Class 1 malocclusion can occur with both type 2 and type 3.
Class 3 malocclusion, an underbite, are also really recognizable. Most people will recognize the jaw jutting out and it almost looks like a bulldog when people smile.
Class 2 malocclusion are little bit more difficult to recognize. Since so many people have this type of malocclusion, we’ve become used to a recessed jaw and a shorter lip to chin ratio. But, as soon as you look at the teeth, you will notice that the upper teeth are in front of the lower teeth.
Proper Teeth Alignment - How Should Your Teeth Be Aligned?
Dentist agree that the teeth should come together with less than 1 millimeter of displacement between any one matching pair of teeth. They also agree that it is an exceptionally rare person that actually has this. Most people, virtually every person, has some form of malocclusion.
Since perfect teeth are a rarity, dentist have agreed that if a person is not experiencing any pain or problems, that a malocclusion is not a problem. Most will leave a minor malocclusion alone, knowing an attempt to fix might cause a further problems down the road.
Upper and lower teeth alignment should occur when the majority of teeth come together so that chewing and speaking are not disrupted in any way. This is especially important for the molars and incisors. Since many malocclusion do not affect the molars, many dentists leave it alone.
Improper Teeth Alignment
If you believe that you or your child has a malocclusion, it should be checked out by a dentist. Your dentist will be able to tell you if this is something that will resolve on its own or if it might need further treatment.
Problems with Malocclusion
Effect of Malocclusion to Speech
One of the most serious issues with malocclusion occurs when the speech patterns are disrupted. While sound is generated by the vocal cords, the formation of letters and specific syllables are created by the lips and tongue. Both the lips and tongue are formed and controlled by the jaw.
Generally, a gap will cause whistling to be heard within speech. It often does not cause slurring or missed words. Crooked teeth rarely cause speech problems.
An overbite may cause slurring with some words, but it takes a severe overbite in order to cause this. Generally, there are very little speech problems that occur with an overbite.
And underbite causes the most amount of speech problems. Because the jaw is jetted forward, the lips have a more difficult time coming together and forming fine speech patterns. With the lower jaw forward, the tongue is farther forward. There may not be enough room for the tongue to form proper syllables without it being interfered with by the upper teeth.
Malocclusion Leads to Tooth Decay
Anytime the teeth are out of alignment, it can lead to tooth decay. The most often happens with teeth that are crowded and with teeth that have gaps.
Being more careful with brushing and flossing can reduce chances of tooth decay.
Reasons For Malocclusion
Malocclusion Due to Mouth Breathing
A class 3 malocclusion can occur because of mouth-breathing. For some, in order to relax the throat, a person will push their jaw forward as they breathe through their mouth. Overtime, this can develop into a habit and the jaw can remain pushed out. It can causes pain within the jaw, teeth grinding and weakness within the draw.
Malocclusion Due to Tongue Thrust
Class 1 malocclusion are usually caused due to the tongue pushing against certain teeth. There are many reasons why a person would push their tongue into their teeth, ranging from pain and irritation, all the way through to an unconscious behavior. As the tongue pushes against the teeth, the teeth grow and develop to move away from the pressure. It’s the same principle that braces work on. As the teeth move, problems set in.
This is actually one of the easiest habits to break. And unless the tooth displacement become severe, it may not even need to be treated.
Malocclusion Due to Bad Habits
Along with the tongue pushing against teeth, there are many bad habits that could cause malocclusions. As we said before, type 2 and type 3 malocclusions are often caused by thumb sucking and pacifiers. The motion of sucking can either pull the top jaw forward, push the lower jaw back, or pull the lower jaw forward. Since children develop many of their habits earlier in life, this can cause lifelong problems. Dentists recommend having a child stop sucking their thumb or using a pacifier as early as possible.
Malocclusion Due to Bruxism
Malocclusion due to teeth grinding (Bruxism) is not as common as the grinding being caused by the malocclusion. However, many the malocclusions are discovered, or rather looks into, when grinding becomes evident.
Grinding often occurs because of pain. Even if a person does not aware of the level of pain, the jaw will try and move in certain ways to relieve the pain. This can develop into the habit of grinding. Unfortunately, this is a habit that is difficult to break because it often occurs at night. Mouthguards are often used to stop the grinding, it can also be used to fix a small malocclusion.
Malocclusion Due to Wisdom Teeth
The class 1 malocclusion of crowded teeth are often caused by wisdom teeth. As the wisdom teeth come in, they will push other teeth out of the way to make room. This can lead to any teeth being out of alignment, including the center two front teeth.
Dentist will often remove the wisdom teeth before they begin coming in in order to avoid this problem.
Malocclusion Due to Trauma
Any trauma to the jaw, neck, or head can cause malocclusion. It can form gaps, crooked teeth, an overbite or underbite depending on the injury. If surgery needs to be done on the head or neck, the results can be malocclusion.
If you have experienced trauma that causes any issues with your head or not, we recommend visiting a dentist in order to make sure that problems can be avoided.
Living with Malocclusion
In most cases, minor malocclusions are something that are not noticed. Most people choose to live with the issue rather than putting themselves through the pain and misery of getting it fixed. For very minor problems, most dentists don’t even recommend a treatment.
For most people, it is actually recommended that if the malocclusion can be found in childhood or teenage years, to fix it then. Because children continue to grow until their twenties, the fixes are easier and less painful the earlier they happen. They can also be longer lasting than when done as an adult.
Also, the earlier the malocclusion is found, the easier the treatment can be and the more cost-effective.
Celebrities with Malocclusion
Just like most of the population, pull celebrities have some sort of malocclusion.
Anna Paquin has a gap.
Kirsten Dunst has overlapped teeth.
Anna Kendrick has an overbite.
Kelly Osborne has an underbite.
How To Prevent Malocclusion
If your issue is hereditary, there's not much you can do to prevent it. But, there are many things you can do to prevent it from getting worse and to prevent habitual problems.
First, avoid sucking on objects. For children, this is pacifiers and their thumbs. For adults, the most common habits causing malocclusion are pens and cigarettes.
Breathe through your nose. Mouth-breathing can cause all sorts of problems, not just pushing your teeth out of alignment. It increases the bacterial contents the mouth, increases gum decay, and can even cause lung problems.
Be conscious of what your tongue is doing in your mouth. If you find your tongue pushing against any part of your mouth, learn to break the habits.
For those that snore or have sleep apnea, be sure to get it checked out and then talk to your dentist. There could be things that are causing the apnea and snoring that are dental related. You can try a sleep aid mouthguard * for this purpose.
For many people with malocclusions, they grind their teeth. If your dentist even hints at that this might be a problem, look at getting a mouthguard * to help reduce the wear and tear on your teeth. It may also stop any malocclusion from progressing.
Malocclusion Treatments
How to Correct Malocclusion without Surgery?
Most fixes for malocclusion are without surgery. They can be something from simple exercises do retainers to braces. Generally, surgery is reserved only for the most severe cases.
Exercises for Malocclusion
For minor overbites and underbites, your dentist may recommend using exercises to help reduce the displacement. The simple act of pushing your jaw to correct the alignment may be all that’s needed to fix the problem. We recommend working with your dentist for the exact exercises, and when and how to use them so you don’t cause further problems.
Generally, exercises are given for all types of problems that require retainers and braces. Make sure you pay attention to these exercises because they can reduce the amount of time you need to wear the corrective devices.
Malocclusion Treatment without Braces
Mouthguard for Malocclusion
A nighttime mouthguard is a simple way to fix minor malocclusion. It is simply slipped over the teeth and remains there until morning. Generally, people need to sleep between seven and nine hours a night in order to have the mouthguard be effective. For those of us with shorter sleeping schedules, the mouthguard may not be in your mouth long enough to actually work.
Retainer for Malocclusion
As the problems become more serious, a dentist may move into the realms of retainers and braces. Retainers are easy and lower-cost ways to move teeth, if the problem isn’t too severe. A retainer will be fit to your mouth and changed as needed.
Many times, retainers are used in order to keep the teeth and jaw in place once braces are finished doing their work. They may be used for a period of years or for the rest of a person’s life.
Invisalign for Malocclusion
Invisalign has produced several products that have been designed to help various types of problems. For the longest time, only class 1 malocclusion could be fixed by the Invisalign retainer system. Now, for certain types of underbites and overbites, Invisalign can be used to help reset the job.
Orthodontics for Malocclusion
Malocclusion with Braces
For more problematic issues, braces may be the only solution. For larger gaps, crooked teeth, and underbite and overbite, braces may be the only thing that help. It is the most common method to fix teeth in children and teenagers.
Braces provide a constant low-level pressure against certain teeth and the draw in order to move it into place. Overtime, the changes become permanent. When done properly there should be no pain or damage to your teeth or mouth.
Surgery for Malocclusion
Only the most severe problems require surgery. It is rarely used for gaps or crooked teeth. Generally, it is only use on very young children and adults with severe over or under bite problems.
Conclusion
There are many types of problems that occur in the mouth and both you and your dentist can work to create the best and longest-lasting solution to any of the problems. Many times, you don’t need a fix at all. But if you do, we really recommend you work with your dentist.
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