What Is Malocclusion
Malocclusion means the teeth are not aligned properly.
Causes of Malocclusion
Occlusion refers to the alignment of teeth and the way that the upper and lower teeth fit together (bite). Ideally, all upper teeth fit slightly over the lower teeth. The points of the molars fit the grooves of the opposite molar. An ideal occlusion is one when the teeth fit together and work together harmoniously to protect the teeth, bone, gum, muscles, and joints.
Malocclusion is often hereditary, and can be caused by too many or too few teeth, or too much or too little space between the teeth. Malocclusion can result from irregular mouth and jaw size, variations in the size or structure of either jaw may affect its shape, as can birth defects such as cleft lip and palate. Other causes of malocclusion include:
* Childhood habits such as thumb sucking, tongue thrusting, pacifier use beyond age 3, and prolonged use of a bottle
* Extra teeth, lost teeth, impacted teeth, or abnormally shaped teeth
* Ill-fitting dental fillings, crowns, appliances, retainers, or braces
* Misalignment of jaw fractures after a severe injury
* Tumors of the mouth and jaw
There are different categories of malocclusion.
* Class 1 malocclusion is the most common. The bite is normal, but the upper teeth slightly overlap the lower teeth.
* Class 2 malocclusion, called retrognathism or overbite, occurs when the upper jaw and teeth severely overlap the bottom jaw and teeth.
* Class 3 malocclusion, called prognathism or underbite, occurs when the lower jaw protrudes or juts forward, causing the lower jaw and teeth to overlap the upper jaw and teeth.
Symptoms
* Abnormal alignment of teeth
* Abnormal appearance of the face
* Difficulty or discomfort when biting or chewing
* Speech difficulties (rare) including lisp
* Mouth breathing (breathing through the mouth without closing the lips)
Exams and Tests
Most problems with teeth alignment are discovered by a dentist during a routine exam. If there is any problem, the dentist will usually refer you to an orthodontist for diagnosis and treatment. Dental x-rays and plaster molds of the teeth are often needed to make a diagnosis of Malocclusion.
Treatment
Malocclusion is the most common reason for referral to an orthodontist.
Malocclusion can be a problem because it interferes with proper chewing, crooked teeth that aren’t aligned properly don’t work as well as straight ones. Chewing is the first part of eating and digestion, therefore it’s important that teeth can do the job. Teeth that aren’t aligned correctly can also be harder to brush and keep clean, which can lead to tooth decay, cavities, and gum disease (gingivitis). People who have crooked teeth may feel self-conscious about how they look; braces can help them feel better about their smile and their appearance.
The goal is to correct the positioning of the teeth. Braces or other appliances may be used. Metal bands are placed around some teeth, or metal, ceramic, or plastic bonds are attached to the surface of the teeth. Wires or springs apply force to the teeth.
One or more teeth may need to be removed if overcrowding is part of the problem. Rough or irregular teeth may be adjusted down, reshaped, and bonded or capped. Misshapen restorations and dental appliances should be repaired. Surgery may be required on rare occasions. This may include surgical reshaping to lengthen or shorten the jaw (orthognathic surgery). Wires, plates, or screws may be used to stabilize the jaw bone, in a similar manner to the surgical stabilization of jaw fracture.
It is important to brush and floss your teeth every day and have regular visits to a general dentist. Plaque accumulates on braces and may leave permanent stains on the teeth or cause tooth decay if not properly cared for.
Even though the teeth have been successfully moved, they are still not completely stable, they need to settle in their corrected positions until the bones, gums, and muscles adapt to the change. This is usually accomplished with the use of retainers, which work by retaining the straight position of the teeth.
Most retainers need to be worn all the time for the first 6 months, then usually only during sleeping. How long a retainer must be worn depends on the patient — one person might wear it for a few months, while another might have to wear it for several years.
Outlook (Prognosis)
Early detection and treatment may optimize the time and method of treatment needed, alignment is easier, faster, and less expensive to treat when corrected early. Treatment is most successful in children and adolescents because their bone is still soft and teeth are moved more easily. Treatment may last 6 months to 2 or more years, depending on the severity of the case. Treatment of orthodontic disorders in adults is often successful but may require longer use of braces or other devices.