What is a Malocclusion?

A malocclusion is an incorrect relationship between the maxilla (upper jaw) and the mandible (lower jaw), or a general misalignment of the teeth.  Malocclusions are so common that most individuals experience one, to some degree.  The poor alignment of the teeth is thought to be a result of genetic factors combined with poor oral habits, or other factors in the early years.

Moderate malocclusion commonly requires treatment by an orthodontist.  Orthodontists are dentists who specialize in the treatment of malocclusions and other facial irregularities.

The following are three main classifications of malocclusion:

  • Class I – The occlusion is typical, but there are spacing or overcrowding problems with the teeth.

  • Class II – The malocclusion is an overbite (the upper teeth are positioned too far forward relative to the lower teeth).  This can be caused by the protrusion of the upper jaw and/or teeth or retrusion of the lower jaw and/or teeth.

  • Class III – Prognathism (also known as “underbite”) is a malocclusion caused by the lower teeth being positioned further forward than the upper teeth.  An underbite usually occurs when the lower jawbone is large or the upper jawbone is short.

Reasons for treating a malocclusion

A severe malocclusion may lead to skeletal disharmony of the lower face.  In a more extreme case, the orthodontist may work in combination with a maxillofacial surgeon to reconstruct the jaw.  It is never too late to seek treatment for a malocclusion.  Children and adults alike have completed orthodontic realignment procedures and have been delighted with the resulting even, straight smile.

Here are some of the main reasons to seek orthodontic treatment for a malocclusion:

  • Reduced risk of tooth decay – A malocclusion often causes an uneven wear pattern on the teeth.  The constant wearing of the same teeth can lead to tooth erosion and decay.

  • Better oral hygiene – A malocclusion can be caused by overcrowding.  When too many teeth are competing for too little space, it can be difficult to clean the teeth and gums effectively.  It is much easier to clean straight teeth that are properly aligned.

  • Reduced risk of TMJ – Certain types of malocclusion may lead to an increased risk of Temporomandibular joint (TMJ) disorder.

How is a malocclusion treated?

A malocclusion is usually treated with orthodontic braces.  The orthodontist takes panoramic and cephalometric radiographs, conducts visual examinations, and takes dental impressions of the teeth before deciding on the best course of treatment.  If a malocclusion is obviously caused by overcrowding, the orthodontist may decide that extraction of teeth is the only way to create enough space for the realignment.  However, in the case of an underbite, crossbite or overbite, there are several different orthodontic appliances available, such as:

  • Fixed braces – This type of appliance consists of brackets cemented to each tooth and an archwire that connects each brace.  The orthodontist adjusts or changes the wire on a regular basis to move the teeth into proper alignment.

  • Removable devices – There are many non-fixed (removable) orthodontic appliances available to treat a malocclusion.  Retainers, headgear, and elastics are among the most common.  Retainers are generally used to hold the teeth in their corrected position following orthodontic treatment, however they can also be modified to improve mild misalignment of teeth.

  • Clear Aligners (Including Invisalign®) – These dental aligners are removable and virtually invisible to the naked eye.  Clear aligners work similarly to fixed orthodontic braces but they have the added advantage of being easily removed for eating.

If you have any questions about malocclusions, please contact our office.

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