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What is a Malocclusion?

A malocclusion is an incorrect relationship between the maxilla (upper arch) and the mandible (lower arch), 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 other teeth.

  • Class II – The malocclusion is an overbite (the upper teeth are positioned further forward than the lower teeth).  This can be caused by the protrusion of anterior teeth or the overlapping of the central teeth by the lateral 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 jawbone is large or the maxillary bone is short.

Reasons for treating a malocclusion

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 wear – A malocclusion often causes an uneven wear pattern on the teeth.  The constant wearing of the same teeth can lead to weakening of the teeth.

  • 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.  Areas that are difficult to clean are at increased risk for decay and gum disease.  It is much easier to clean straight teeth that are properly aligned. 

  • Achieving skeletal harmony – 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 oral and maxillofacial dental specialist to reconstruct the jaw.

How is a malocclusion treated?

A malocclusion is usually treated with braces.  The orthodontist takes x-rays, conducts visual examinations, dental impressions of the whole mouth, and photographs before deciding on the best course of treatment.  If a malocclusion is obviously caused by overcrowding, the orthodontist may decide an extraction is the only way to create enough space for the realignment.  In the case of an underbite, crossbite or overbite, there are several different orthodontic appliances available.

Some orthodontic appliances:

  • Fixed braces – This consists of brackets cemented to each tooth, and an archwire that connects each one.  The orthodontist adjusts or changes the wire on a regular basis to train the teeth into proper alignment.  There are additional appliances that may be used in coordination with fixed braces.  One example is an expander.

  • Removable devices – There are many non-fixed orthodontics appliances.  Retainers and headgear are amongst the most common. 
  • Invisalign® or other clear aligners – These dental aligners are removable clear trays. Not all patients are candidates for Invisalign®.

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