Malocclusion

A  healthy occlusion refers to teeth and jaws that are well aligned and in  functional harmony. When a malocclusion, more commonly referred to as a  “bad bite” is present, either the teeth, the jaws or both are not in  the correct positions or proper relationships.

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There are many dental issues, which can affect the positions of the teeth and jaws that require orthodontic treatment to resolve. A malocclusion may be due to crowding, spacing, problems  with jaw development, or the failure of certain teeth to erupt into  their proper positions. Harmful oral habits such as finger sucking or  tongue thrusting can also cause bite problems as well as the drifting of  teeth into the unrestored spaces left by dental extractions or tooth loss. Sometimes, teeth develop in the jawbone facing in  directions that prevent them from erupting at all. These teeth are  referred to as impacted.

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Both genetic and environmental factors contribute to the development of a malocclusion. Injuries that cause a misalignment of the jaws and diseases such as oral tumors can also play a role in changing the occlusion.

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In children,  most problems involving the alignment of the teeth and the growth of the  jaws can be detected by the time they are in the first or second grade.  That is why the American Association of Orthodontists recommends that  all children have a check up with an orthodontic specialist no later  than age 7. For children, most orthodontic treatment begins between the  ages of 9 and 14. However, earlier and interceptive care is sometimes  required at a younger age. Likewise, in cases of significant problems  involving jaw relationships, orthodontic care may involve treatment  throughout growth and development.

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It is  important to note that a malocclusion can be treated at any age. Today  greater numbers of adults are actively seeking treatment for either crooked teeth or jaw problems that have bothered them since childhood, as well as to address teeth that have shifted over time due to extractions, habits, or abnormal bite patterns.

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While  malocclusions can be observed with a clinical exam, a more comprehensive  assessment is required to make a complete diagnosis and to develop the  most appropriate plan of care.

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Types of Malocclusions

Malocclusions  typically fall into three major types based on the kinds of  discrepancies in alignment and bite that are present. They can be either  due to issues of dental alignment or skeletal jaw disharmonies, or even  a combination of both problems.

• Class I: This is the most common type of malocclusion and is characterized by a normal bite with problems of tooth alignment

• Class 2:  This malocclusion is characterized by an “overbite” where the top teeth  are positioned ahead of the bottom teeth and demonstrate a more  extensive overlap

• Class 3:  This malocclusion is characterized by an “underbite” or mandibular  prognathism, causing the lower jaw and anterior teeth to be in front of  the upper teeth.

While most  malocclusions will respond to the appropriate orthodontic treatment,  some require a combination of orthodontic treatment and orthognathic  surgery to improve the skeletal jaw relationships.