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Malocclusion

Malocclusion or ‘poor bite’ is a condition caused due to the misalignment of the teeth, i.e. the upper and the lower teeth do not line up properly. Normally, the upper teeth are aligned slightly over the lower teeth and the tips of the molars fit into the grooves of the opposite molars. The upper teeth prevent the biting of cheeks and lips while the lower teeth protect the tongue. In people with malocclusion, there is a disturbance in this alignment.

Some of the malocclusions are minor which do not need any repair. However, in most of the cases, a correction is necessary to preserve the vital functions of the teeth and protect the overall oral health.

Types

There are three main categories of malocclusion:

  • Class 1 malocclusion is the type in which the upper teeth partly overlap the lower teeth. This is the most common type which does not affect the biting.
  • Class 2 malocclusion (overbite or retrognathism) is the type in which the upper teeth and jaw severely overlap the lower teeth and jaw.
  • Class 3 malocclusion (underbite or prognathism) is the type in which the lower teeth and jaw slightly overlap the upper teeth and jaw.

Symptoms

The common symptoms presented by people with malocclusion include:

  • Misalignment of the teeth
  • Difficulty to bite or chew the food
  • Change in appearance of the face
  • Mouth breathing
  • Difficulty with speech (rare), including the development of a lisp
  • Frequent biting of the tongue or inner cheeks

Causes

Malocclusion is usually inherited. The other causes for malocclusion include:

  • Impacted or abnormally shaped teeth
  • Premature or congenital loss of teeth or missing teeth
  • Tongue thrusting or thumb sucking habits
  • Long-term use of bottle feeding
  • Frequent use of pacifier beyond 3 years of age
  • Injuries that lead to the misalignment of the jaw
  • Improper fitting of the dental fillings, braces, crowns or other appliances
  • Tumors in the mouth or jaw

Diagnosis

The dentist can identify the malocclusion through a routine dental examination. Physical examination may include examining the teeth, pulling the cheeks outwards and checking for certain defects during biting. Sometimes the dentist may order for dental, facial, head or skull x-ray to determine the type and severity of malocclusion.

Treatment

Treatment is usually provided in several stages and depends on the type and severity of malocclusion.

Most of the cases of malocclusion are treated with braces. These are usually effective when used during childhood or early adolescence because the jaws are in the developmental stage during this age. However, it is possible to correct the malocclusions even in adults by a well-trained orthodontist. A retainer may be necessary along with braces to stabilize the teeth.

  • In addition to braces, brackets may be bonded to the teeth using wires and elastics to correct misalignment.
  • Extraction of the primary or the permanent teeth may be suggested if malocclusion is due to overcrowding of the teeth.
  • Rarely, a surgery may be necessary to lengthen or shorten the lower jaw and allow for a proper alignment.

Complications

Treatment of malocclusion can lead to the following complications:

  • Pain and discomfort
  • Tooth decay
  • Difficulty with chewing and speech
  • Irritation of the mouth due to the dental appliances such as braces

Self-care

In addition to the treatment, some of the self-care measures which are required to maintain dental hygiene:

  • Brushing the teeth twice daily with a fluoride containing toothpaste and flossing the teeth once daily
  • Regular dental check-ups.
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