Malocclusion

Malocclusion can be classified into different types depending on how the upper and lower teeth fit together:

• Class I malocclusion (common type): The bite is normal, but some teeth may be crowded, rotated, or spaced irregularly.
• Class II malocclusion (overbite): The upper front teeth and jaw significantly overlap the lower teeth and jaw. This may cause a “buck teeth” appearance.
• Class III malocclusion (underbite): The lower teeth and jaw extend forward, so the lower front teeth sit ahead of the upper front teeth. This may cause the chin to appear more prominent.
• Open bite: The upper and lower teeth do not touch when the mouth is closed, leaving a visible gap.
• Crossbite: Some upper teeth bite inside the lower teeth instead of outside, which may cause uneven wear of teeth.
• Overjet: The upper front teeth stick out too far forward compared to the lower front teeth.

Malocclusion generally presents with symptoms such as:

• Noticeable overbite (overjet or retrognathism: the lower teeth are too far behind the upper teeth) or an underbite (the upper front teeth are too far behind the lower front teeth), affecting the appearance of an individual
• Difficulties or discomfort while biting correctly (open bite) or chewing
• Mouth breathing
• Speech difficulties (rare), such as the presence of a lisp 

Malocclusion has several causes:

• Teeth being too large relative to the jaw size: This leads to overcrowding of teeth and disturbs the alignment between the upper and lower jaws
• Thumb-sucking habit in a baby or toddler
• Diastema (gaps between teeth) due to missing teeth: This causes other teeth to migrate, causing malocclusion.
• Hereditary conditions that affect the jaw: these may cause the misalignment of teeth.
• Tooth grinding (bruxism): Worsens malocclusion over time. 

A dentist assesses for malocclusion using the following methods:

• Oral examination: During routine dental checkups, dentists check the alignment of the teeth.
• Dental X-ray: X-ray imaging may be performed for understanding the patient’s condition better.
• Models or impressions of the teeth: These may be taken for treatment planning. 

Based on these results, a visit to an orthodontist is recommended for treating malocclusion.

The choice of treatment depends on the severity of the malocclusion:

• Tooth braces: The consistent, gentle tug of the braces on the teeth enables the reshaping of the underlying bone in the tooth socket, which causes a permanent shift in the position of the teeth such that they are aligned correctly.
• Clear aligners: These clear acrylic-based devices gradually reposition the teeth such that they are aligned correctly.
• Teeth extraction: Removal of certain teeth may be recommended to ease tooth overcrowding.
• Corrective jaw surgery: The jaw may be surgically repaired to correct inherited/developmental issues or fix jaw fractures that did not heal properly.

Patients should consult a dentist or orthodontist if they notice:

• Difficulty biting, chewing, or closing the mouth comfortably
• Visible misalignment (overbite, underbite, open bite, or crowded teeth)

While malocclusion cannot always be prevented (since genetics play a role), certain measures can help reduce risk:

• Discourage thumb-sucking and pacifier use beyond early childhood
• Encourage proper oral habits (avoiding nail-biting, pencil chewing, etc.)
• Ensure children receive timely dental checkups to detect misalignment early 

For diagnosis and treatment of malocclusion, consult an Orthodontist. In severe cases requiring surgical correction of the jaw, an Oral and maxillofacial surgeon may also be involved.