How to fix malocclusion?

Dr.-B.-Lipovetskiy (1)

The author of the article

Boris Lipovetskiy, DMD, 31 years experience

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Misaligned teeth are not just a cosmetic issue. Dr. Lipovetskiy takes a holistic approach and links malocclusion to serious problems such as jaw pain, migraines, and sleep disturbances.

In this article, the dentist defines malocclusion and explores its types, from deep bite to crossbite. You’ll learn about the symptoms and when it’s time to visit a dental clinic. Most importantly, we’ll show the available treatment options for correcting malocclusion.

What is Malocclusion?

Malocclusion is the misalignment of teeth or an improper relationship between the upper and lower jaws. It can range from a minor bite issue caused by slightly crooked teeth to a more severe jaw misalignment, such as deep bite or crossbite.

Malocclusion affects the chewing function, creating uneven pressure on the teeth and jaw muscles. Its impact on the oral system includes:

lipovetski-portrait.jpg

Over 31 years in dentistry

"Correct your malocclusion with Invisalign or CandidPro aligners at our clinic and get a $700 discount on treatment! We specialize in solving even the most complex bite problems using advanced technology."

What Does a Correct Bite Look Like?

Normal teeth bite occlusion
  • The upper front teeth (incisors) overlap the lower front teeth by about 1-2 mm.

  • The upper and lower teeth fit together in a "lock-and-key" relationship: the cusps of the upper teeth fit into the grooves of the lower teeth.

  • The molars should come together in a way that distributes the chewing force evenly, without placing excessive pressure on any individual teeth or the jaw joints.

Symptoms of Malocclusion

1. Crooked or Misaligned Teeth

Teeth may appear crowded, overlapping, or unevenly spaced. This not only affects the aesthetics of the smile but also makes it harder for the patient to thoroughly clean hard-to-reach areas, increasing the risk of plaque buildup and cavities.

2. Jaw Pain or Clicking

Misaligned teeth cause uneven pressure on the muscles and joints involved in chewing. This can lead to discomfort or pain near the ear, particularly in the temporomandibular joint (TMJ), and patients may experience clicking or popping sounds when opening or closing mouth.

3. Frequent Headaches

Uneven distribution of chewing forces causes certain jaw and facial muscles to overwork, which can lead to muscle tension and trigger headaches.

4. Excessive Tooth Wear

Incorrect alignment leads to improper contact between the upper and lower teeth, causing them to wear down faster. This can result in chipped enamel, micro-cracks, and increased tooth sensitivity.

5. Speech Difficulties

Teeth play an important role in sound formation. Significant misalignment can cause speech impediments, such as lisping or difficulty pronouncing certain words.

6. Mouth Breathing

When the upper or lower jaw excessively overlaps the other, it can obstruct the nasal airway, making it harder to breathe through the nose. This can lead to dry mouth and an increased risk of tooth or gum infections.

7. Difficulty Chewing or Biting

Misaligned or tilted teeth can make it hard for patients to properly chew or bite food. This may result in discomfort or pain during eating.

8. Gum Inflammation and Tooth Decay

Crowded teeth or other misalignment issues create areas where it's difficult to remove harmful bacteria, leading to plaque buildup. This increases the risk of gum inflammation and infection that can affect both teeth and gums.

9. Facial Asymmetry

In some cases, malocclusion can cause facial disproportion, especially around the jaw, chin, or cheeks, affecting the overall appearance of the face.

Causes of Malocclusion

There are many causes of malocclusion, with some of the most common being:

  • Genetic Factors

    Malocclusion is often hereditary. People can inherit traits from their parents such as crowded teeth, spacing issues, jaw size discrepancies, or alignment problems.

    Another common genetic cause is jaw size mismatch, where the upper and lower jaws do not align properly, leading to overbites, underbites, or crossbites.

  • Childhood Habits

    Habits like thumb sucking or prolonged pacifier use beyond infancy can cause the front teeth to shift, leading to open bites or crossbites.

    Another habit is tongue thrusting, where the tongue pushes against the front teeth during swallowing, gradually moving them out of alignment.

  • Jaw Injuries

    Trauma, such as a severe blow or fracture, can alter the position of the jaw, resulting in a misaligned bite. Additionally, the loss of teeth due to injury can cause neighboring teeth to shift into the empty space, further disrupting the bite.

  • Bruxism (Teeth Grinding)

    Grinding or clenching teeth applies continuous pressure on them, which over time can cause teeth to shift and become misaligned.

Types of Malocclusion

Types of bite depending on the ratio of the jaws

Depending on the relationship between the upper and lower jaws and the spacing of the teeth, dentists classify malocclusion into the following types:

Class I Malocclusion

This is the most common type of malocclusion. In this case, the molar relationship is normal, meaning the molars align correctly, but some of the other teeth may be misaligned. This can result in crowding (where teeth overlap) or spacing issues (where there are large gaps between teeth).

Even though the jaws are correctly aligned, the crooked teeth can affect the appearance of the smile and make it more difficult for the patient to clean areas that are hard to reach, increasing the risk of dental issues like cavities and gum disease.

Class II Malocclusion

In this type, the upper jaw and teeth protrude significantly beyond the lower jaw. This occurs either due to a larger upper jaw or a smaller lower jaw.

Class II malocclusion can be further divided into two types based on the angle of the front teeth:

  • Type 1: The upper front teeth are tilted forward, making the overbite and tooth misalignment more pronounced.
  • Type 2: The upper front teeth are tilted inward, reducing the visible severity of the overbite.

Due to the protrusion of the upper teeth, not only is the appearance of the smile affected, but it can also make biting into food more difficult and increase the risk of injury to the front teeth.

Class III Malocclusion

In Class III malocclusion, the lower jaw protrudes forward, causing the lower teeth to overlap the upper teeth. This type of misalignment can make chewing difficult and may lead to speech difficulties.

When the lower jaw is significantly extended, it can alter the proportions of the face, making the chin appear larger and more pronounced.

How Different Types of Malocclusion Appear

There are certain defects that can be associated with any class of malocclusion:

Crowded Teeth

Crowding occurs when there isn’t enough space in the jaw for all the teeth to be properly aligned. This results in overlapping, crooked, or shifted teeth.

crowded teeth

Large Gaps

Gaps between teeth can occur when teeth are missing, smaller than average, or there is too much space in the jaw.

extra space between teeth

Open Bite

An open bite is characterized by the upper and lower teeth not touching when the jaw is closed, leaving a visible gap, typically in the front teeth.

gap between teeth while biting down

Crossbite

In a crossbite, some upper teeth sit inside the lower teeth when the jaws are closed, and vice versa. This can affect a single tooth or a group of teeth, and may occur on one or both sides of the mouth.

upper teeth fit inside lower teeth

Deep Bite

A deep bite occurs when the upper jaw is overly projected forward, causing the upper teeth to cover more than half of the lower teeth. This can lead to inflammation of the palate, as the lower teeth may press against it.

front teeth overlap lower teeth

Underbite (Prognathism)

In this case, the lower jaw is pushed forward, causing the lower teeth to overlap the upper teeth.

lower teeth jut out futher than upper teeth while at rest

Some patients hesitate to seek treatment for malocclusion due to concerns about long, costly, or uncomfortable processes. However, we offer a modern approach to bite correction: aligners. Here’s why they are the preferred solution:

  • Invisible: Aligners are made from transparent plastic, making them discreet and aesthetically pleasing, without attracting attention.
  • Comfortable: Unlike traditional braces, aligners have no metal brackets or wires, making them much more comfortable. They don’t irritate the gums and are barely noticeable in the mouth.
  • Removable: Patients can remove aligners during meals or for thorough cleaning, ensuring better hygiene for both the teeth and the aligners.
  • Effective: Aligners gradually shift teeth into the correct position. With regular use, patients often see significant improvements over the course of treatment.
lipovetski-portrait.jpg

Over 31 years in dentistry

"We also offer the convenience of paying through Care Credit, allowing patients to break the cost of treatment into manageable monthly payments. This enables you to focus on achieving a healthy, beautiful smile without worrying about upfront costs."

Why is it important to treat malocclusion?

Treating malocclusion is essential not only for achieving a beautiful smile but also for improving overall health. Ignoring jaw and tooth alignment issues can lead to the following problems:

  • Cavities: When teeth are misaligned, plaque and harmful bacteria accumulate in hard-to-reach areas. These bacteria multiplies, gradually eroding the enamel and leading to the development of cavities.
  • Gum inflammation: Misaligned teeth allow plaque to build up along the gum line, increasing the risk of gingivitis and periodontitis.
  • Temporomandibular Joint Disorders (TMJ): An improper alignment between the upper and lower jaws causes uneven distribution of chewing forces. The temporomandibular joint (TMJ) connects the jaw to the skull, and when under excessive pressure, its function is disrupted—resulting in pain, clicking sounds when opening or closing the mouth, and difficulties while chewing.
  • Tooth enamel wear and damage: Misaligned upper and lower teeth wear down more quickly. The enamel (the outer protective layer of the teeth) is eroded, exposing the dentin (the softer middle layer). As a result, teeth become more sensitive to temperature changes, sweets, and acidic foods.

You won't need to visit the dentist frequently for consultations. The Candid Monitoring system is a unique technology that allows you to monitor your treatment progress remotely. Patients regularly send photos of their bite through the mobile app, and dentists track the progress and provide recommendations online.

How Does Malocclusion Treatment Work?

Aligners are a simpler and more convenient alternative to traditional braces. The treatment process involves several stages:

1. Consultation

You will discuss your concerns and goals with the dentist. The dentist will assess the condition of your teeth, gums, and jaw alignment. Then, they will explain how the aligner treatment for malocclusion works.

2. Diagnosis and Smile Design

The dentist will order X-rays to examine the structure of your jaws and the positioning of the tooth roots. Additionally, they will take digital scans of your teeth to create a detailed 3D model of your mouth and develop a personalized treatment plan.

At this stage, the dentist calculates the precise direction and force needed to move each tooth for optimal alignment.

You'll also get to see a virtual simulation of how your teeth will look after treatment, giving you a clear vision of the expected result.

3. Installation and Regular Check-Ups

After the diagnosis, a set of custom-made aligners will be created to fit your teeth exactly. Once your aligners are ready, you’ll return for a quick fitting. You'll receive several aligners, each designed to gradually move your teeth. Each set is typically worn for 1-2 weeks, depending on your treatment plan.

Before and After Malocclusion Treatment

Malocclusion before Malocclusion after

Case:

The patient came to our clinic due to the misalignment of several teeth. The upper incisors were too close together, overlapping one another and incorrectly covering the lower teeth.

Treatment:

Dr. Lipovetskiy conducted a thorough diagnosis, created a 3D model of the patient’s teeth, and developed a detailed treatment plan. He calculated how the teeth needed to shift and the exact pressure required to achieve the desired result. Based on this plan, Candid Pro aligners were custom-made for the patient.

Result:

The upper teeth became more aligned, and the incisors were repositioned and tilted correctly. The upper jaw was also adjusted, allowing the upper teeth to properly meet the lower teeth. The patient was thrilled with their improved smile.

lipovetski-portrait.jpg

Over 31 years in dentistry

"At our clinic, we use Invisalign and Candid Pro aligners, which are custom-made for each patient. We also offer smile design, allowing us to calculate the expected treatment outcome and develop the most effective alignment plan during the diagnostic phase."

What is the Best Way to Correct Malocclusion?

Aligners and braces differ in several key aspects:

Effectiveness
  • Braces: Are ideal for treating complex malocclusion issues, such as severe crowding or other significant tooth alignment problems. They are often used when more extensive corrections are needed.
  • Aligners: Effective for mild to moderate cases of malocclusion. Aligners work in sets, with each aligner gradually shifting the teeth into the desired position.

At our clinic, we only offer aligner treatments.

Convenience
  • Braces: Braces are fixed to your teeth, working 24/7. However, they require adjustments and check-ups with the dentist every 4-6 weeks. Braces can make it more difficult to clean teeth, especially around the brackets, and you must avoid hard and sticky foods that can damage the system.
  • Aligners: Transparent aligners are designed for convenience. They can be removed during meals, allowing you to eat any type of food and maintain your usual oral hygiene routine. Aligners also require fewer dental visits, as patients receive several sets in advance and can consult with the dentist online.

Aligners seamlessly integrate into your daily life. There are no food restrictions, and fewer dental visits make it easier to fit treatment into a busy schedule.

Comfort
  • Braces: Patients may feel discomfort or mild pain after the initial installation and after each adjustment. This discomfort comes from the pressure applied to the teeth, and it takes time for the body to adjust. Brackets can also rub against and irritate the gums, cheeks, and lips.
  • Aligners: Made from smooth plastic, aligners don’t irritate the soft tissues of the mouth. While there may still be some pressure during tooth movement, aligners are generally more comfortable compared to braces.
Aesthetics
  • Braces: Traditional (vestibular) braces are visible, as they are attached to the outer surfaces of the teeth. Metal brackets and wires are noticeable when smiling or talking. Ceramic or sapphire braces may be suggested by the dentist, as they are less visible due to the color of the brackets.

    Lingual braces are placed on the inside of the teeth, making them invisible from the outside.
  • Aligners: Nearly invisible, aligners are a popular choice for patients who want to correct their bite discreetly without drawing attention.

FAQ

Aligners are not recommended for correcting complex orthodontic issues, such as severe jaw misalignment, significant tooth crowding, or tooth rotation (twisting). Dentists may also suggest an alternative treatment if the patient is unable to wear the aligners consistently, as frequently removing them can reduce their effectiveness.