Malocclusion – Meaning, Classification, Definition, Symptoms, Classes, Treatment

Malocclusion refers to the misalignment of upper and lower teeth and jaws, leading to various oral health complications. It encompasses a range of issues, from crooked teeth to severe jaw misalignment, and affects dental health significantly. Understanding malocclusion, its causes, types, and treatment options is vital for maintaining overall dental health.

Key Facts

Malocclusion, colloquially known as a bad bite, refers to any misalignment of the teeth or improper fitting of the upper and lower dental arches

There are several types of malocclusion, including overbite, underbite, and crossbite

Malocclusion can be a hereditary condition or can be acquired

Besides affecting oral health, malocclusion can have implications for general health

Treatment for malocclusion ranges from orthodontic braces and aligners to surgery in severe cases

What is Malocclusion?

Malocclusion is a dental condition where the alignment of teeth, upper and lower jaws, or both, is irregular, meaning there is a misalignment of the teeth or the dental arches do not properly align when the jaws are closed. The term malocclusion is derived from Latin, with mal meaning bad and occlusion meaning closure. Essentially, it translates to a bad closure or bad bite. It can manifest as an open bite, where the upper and lower front teeth do not meet, or as an overbite or underbite, where the upper or lower teeth overlap excessively.

There are different types of malocclusion, such as:

Overbite: Where the upper front teeth significantly overlap the lower front teeth
Underbite: Where the lower teeth are positioned ahead of the upper teeth
Crossbite: When the upper teeth sit inside the lower teeth, which can cause tooth stratification and misaligned jaw growth
Open Bite: Where the front teeth, both upper and lower, are forced outwards to an extent that there is a space between the biting surfaces
Crowding: When there is insufficient space for the normal growth and development of adult teeth

Malocclusion can range from mild to severe and can sometimes lead to complications in speech, eating, and even breathing.

Can Malocclusion Affect My Overall Health?

Yes, malocclusion can have far-reaching impacts on overall health. While it might seem like misalignment of teeth affects only the appearance, it is essential to understand that it can have various health implications:

Difficulty in Chewing and Eating: Misaligned teeth can make it difficult to chew food properly, which can lead to digestive issues.
Speech Impediments: It can affect the way a person speaks, and may contribute to speech issues such as lisping.
Increased Risk of Oral Problems: Malocclusion can lead to difficulty in cleaning teeth properly, which increases the risk of tooth decay and gum disease.
Jaw Problems: The misalignment can put strain on the muscles and jaw, leading to temporomandibular joint disorder (TMD).
Headaches and Neck Pain: The undue stress on the jaw can extend to headaches and neck pain.
Sleep Apnea: Severe malocclusions can contribute to breathing problems during sleep, known as sleep apnea.

Causes of Malocclusion: What Causes Malocclusion?

Malocclusion can be caused by a variety of factors including:

Genetic Factors: The most common cause is hereditary. Inherent issues such as cleft lip or palate, abnormally shaped teeth, or irregular tooth shape. People may inherit a larger or smaller jaw, which can cause spacing or crowding of teeth.
: Habits like thumb sucking,
Developmental Changes: As a child grows, the size and shape of the jaw can change, which can sometimes cause malocclusion.
Environmental Factors – Bad Oral Habits: Habits such as thumb sucking, tongue thrusting, prolonged use of a bottle, or use of a pacifier beyond the age of 3, loss of baby teeth or permanent teeth, and trauma leading to jaw fractures can contribute to the problem.
Impacted Teeth: Impacted teeth or the early loss of baby or adult teeth can result in malocclusion.
Injury or Trauma: An injury that affects the jaw can result in malocclusion.

Does Teeth Grinding (Bruxism) Cause Malocclusion?

Teeth grinding, or bruxism, can contribute to malocclusion. Consistent grinding puts pressure on the teeth and can cause them to shift over time. This shifting can lead to misalignment or worsening of an existing malocclusion. Furthermore, bruxism can cause other oral health issues, such as wearing down the enamel of the teeth, which can contribute to sensitivity and decay. It’s also worth noting that malocclusion can sometimes be a contributing factor to bruxism. Therefore, it is essential to address both issues to prevent a cyclical problem. It is imperative for individuals who have bruxism to discuss with their dentist or orthodontist the options for managing and treating this condition.

Can Malocclusion Cause Temporomandibular Joint Disorders (TMJ)?

Yes, malocclusion can contribute to the development of temporomandibular joint (TMJ) disorders. TMJ disorders refer to a group of conditions that cause pain and dysfunction in the jaw joint and the muscles controlling jaw movement. When teeth do not align properly due to malocclusion, it can place extra stress on the jaw which, over time, can lead to TMJ disorders. This can cause various symptoms, such as jaw pain, headaches, difficulty chewing, and a clicking or popping sound in the jaw when you open or close your mouth.

Symptoms: What Are Typical Symptoms of Malocclusion?

The symptoms of malocclusion can vary greatly depending on the type and severity of the condition.
Here are some typical signs:

Misaligned teeth
Changes in facial appearance
Discomfort when biting or chewing
Speech problems, such as a lisp
Mouth breathing
Frequent biting of the inner cheeks or tongue
Alterations in the alignment of the jaw

In severe cases, malocclusion can even lead to chronic pain in the jaw or headaches.

Diagnosis: How is Malocclusion Diagnosed?

The diagnosis of malocclusion usually involves a thorough dental examination. The dentist will check for abnormalities in your bite by examining your teeth and jaw from various angles. They may also ask about any symptoms you’re experiencing, like difficulty chewing or speaking.
Diagnostic tools for malocclusion include:

Dental X-rays: These images help the dentist view the position of your teeth and jaw to determine if they’re properly aligned.
Impressions of the teeth: This involves biting into a soft material that hardens into a mold, providing a replica of your teeth. The dentist can use this model to examine your bite more closely.

Classification: What Are Malocclusion Classes?

Malocclusion is classified into three major categories, known as Class I, II, and III.

Class I: This is the most common type. The bite is normal, but the upper teeth slightly overlap the lower teeth. This class may include minor irregularities like slightly rotated teeth.

Class II: Also known as distocclusion or overbite, this is where the upper jaw and teeth severely overlap the lower jaw and teeth. It’s further divided into Division 1, characterized by an overjet where the front upper teeth jut out, and Division 2, where the front upper teeth tilt inwards.

Class III: Also known as mesioclusion or underbite, this occurs when the lower jaw protrudes or juts forward, causing the lower teeth to overlap the upper teeth and jaw.

These classes help orthodontists plan appropriate treatment strategies to correct the malocclusion.

Treatment: How Do You Fix Malocclusion?

Treatment for malocclusion depends on the type and severity of the condition, and the age of the patient.
Here are some common approaches to fixing malocclusion:

Orthodontic Braces: This is the most common treatment for correcting malocclusion. Traditional braces or lingual braces apply pressure to the teeth and gradually to correct the alignment of teeth.
Invisible Aligners: Clear aligners such as Invisalign are an alternative to traditional braces. They are less noticeable and can be removed for eating and cleaning. Used in less severe cases for aesthetic correction.
Retainers: After braces or aligners have corrected the teeth, retainers might be used to keep teeth in place.
Palatal Expanders: These are used primarily in children to widen the upper jaw and make room for teeth to grow in properly.
Jaw Re-positioning Appliances: These devices can be used to train the jaw to close in a more favorable position.
Tooth Extraction: In cases of tooth overcrowding or impacted teeth, it might be necessary to remove one or more teeth to make space for the others.
Orthognathic Surgery: In extreme cases, particularly when the misalignment is due to the jaw rather than the teeth and it cannot be corrected with braces alone, surgery may be required.

Each case of malocclusion requires individualized treatment planning, considering the severity, patient’s age, and specific dental problems.

Prevention and Management: Can I Prevent Malocclusion?

While some cases of malocclusion, particularly those caused by genetic factors, cannot be prevented, there are steps that can be taken to minimize the risk of developing or worsening malocclusion:

Early Detection and Intervention: Regular dental check-ups during a child’s early years are key to identifying potential problems with the child’s baby teeth or the development of their permanent teeth.
Correcting Harmful Habits: Addressing and managing contributing factors such as thumb sucking, prolonged use of a pacifier in children and ensuring timely replacement of lost teeth to prevent adjacent teeth from shifting.
Post-Treatment Care: Following orthodontic treatment, maintaining oral hygiene and wearing retainers as prescribed are crucial to prevent relapse.
Wearing a Mouth Guard: For individuals who grind their teeth, wearing a mouth guard can prevent the wear and tear that can contribute to malocclusion.

What Can I Expect If I Have Malocclusion?

If you have malocclusion, you can expect some of the following:

Orthodontic Treatment: You may need to undergo orthodontic treatment which can last from several months to a few years depending on the severity.
Regular Monitoring: Your dentist or orthodontist will want to see you regularly to monitor progress.
Potential Discomfort: Some discomfort or pain is common, especially when adjustments are made to braces or other appliances.
Improved Oral Health and Aesthetics: Once treatment is completed, you can expect improved oral health, easier cleaning, and an enhanced appearance.

How Often Should I See My Orthodontist?

The frequency of orthodontic visits varies based on the type of malocclusion, the treatment plan, and the type of appliances being used. Generally, during active treatment with braces, orthodontists typically schedule appointments every 4 to 8 weeks to make adjustments and monitor progress. It’s important to adhere to the schedule recommended by your orthodontist to ensure the best possible outcomes.

How Often Should I See My Provider for My Regular Dental Care?

Regular dental check-ups are essential for maintaining good oral health. As a general rule, you should aim to visit your dentist every six months. However, this frequency may change depending on your specific oral health condition. For example, those with a high risk of dental disease might need to visit more frequently, while those with excellent oral health may only need to see their dentist once a year. Your dentist will be able to provide a personalized recommendation based on your circumstances.

How Do I Take Care of Myself?

To take care of your oral health, consider the following tips:

Maintain a Good Oral Hygiene Routine: Brush at least twice a day, and floss at least once a day. This will help to remove plaque and prevent tooth decay.
Eat a Healthy Diet: A diet low in sugar can help prevent tooth decay. Eating a variety of foods from all food groups can also promote good oral health.
Avoid Tobacco: Tobacco can harm your mouth in a variety of ways, increasing your risk for tooth decay, gum disease, and oral cancer.
Limit Alcohol: Excessive alcohol can increase your risk of oral cancer.
Wear a Mouthguard: If you play sports, wearing a mouthguard can protect your teeth from injury.

When Should I See My Healthcare Provider?

If you have malocclusion, it’s essential to keep up with your regular dental appointments.
However, you should contact your provider immediately if you experience any of the following:

Severe pain or discomfort
Difficulty chewing or biting
Persistent headaches or jaw pain
Noticeable changes in your bite or the alignment of your teeth

What Questions Should I Ask My Doctor?

Here are some questions you might consider asking your dentist or orthodontist if you’re dealing with malocclusion:

What type of malocclusion do I have?
What is the cause of my malocclusion?
How will malocclusion affect my oral health if left untreated?
What are the treatment options for my type of malocclusion?
What will the proposed treatment involve?
How long will the treatment take?
What will be the cost of the treatment?
Will the treatment cause any discomfort or pain?
What type of care will my teeth require during treatment?
What steps can I take to prevent further dental issues?
Remember, it’s important to ask any questions you might have, and to make sure you understand the answers. Good communication with your healthcare provider is key to successfully managing your oral health.

Bottom line

Very few people have a perfect occlusion, but treating significant malocclusion is crucial for maintaining good oral health, as it is more than a cosmetic concern. Malocclusion, although common, is a complex dental issue with multiple causes and potential treatment options. It involves an abnormal alignment of the upper and lower teeth, which can lead to functional and cosmetic issues. Treatment options are diverse, ranging from orthodontic intervention with braces or clear aligners to dental restoration procedures or even surgery in severe cases. Early diagnosis and treatment planning by a skilled dental health care professional can prevent many oral health complications associated with this condition. If you suspect you have malocclusion, it is essential to consult with a dental professional for a comprehensive evaluation and appropriate treatment plan.
```
This article is complete and was published on July 8, 2023, and last updated on December 22, 2023.
```

Key Facts