Common malocclusions

In the ideal situation, our teeth would bite down in a very specific way to optimize function and oral health. Unfortunately, our teeth are almost never naturally perfect. This causes problems with chewing, oral hygiene, speaking and esthetics.Malocclusion, or ‘bad bite’, is often times a genetic problem. A bad bite can also be caused by environmental problems such as thumb or finger-sucking, mouth breathing, periodontal problems, abnormal swallowing, poor dental hygiene, the early or late loss of baby teeth or poor nutrition. Trauma and other medical conditions such as birth defects may contribute to orthodontic problems as well.

Such common orthodontic abnormalities have been identified as triggers for referral by dentists and dental therapists. If any of these look familiar or you have any questions about your or your child’s bite or teeth, you are welcome to contact us in order to guide you for appropriate diagnosis and treatment plan. Some common problems include:

Anterior crossbite

The upper teeth should fit outside the lower teeth like a lid on a box. While in this problem, the lower front teeth sit in front of the upper front teeth. This can occur with a single tooth or multiple teeth. An anterior crossbite is usually caused by undergrowth of the upper jaw, overgrowth of the lower jaw, or a combination of the two (Class III Relationship). It can also be caused by flared lower incisors, crowded upper incisors or a combination of all the above.

Early correction of crossbite is recommended.; If the anterior crossbite is not addressed receding gums can develop on the lower teeth. The bigger, stronger top teeth can push the lower teeth forward.

Treatment of anterior crossbiteAnterior crossbite can be corrected through growth modification or surgical correction of the jaws, and in some cases extraction of teeth to camouflage the jaw discrepancy.

Posterior crossbite

The upper teeth sit inside the lower teeth, which may cause tooth stratification and misaligned jaw growth due to swinging lower jaw to one side.

Crossbite (anterior and posterior types) should be corrected because it can:

Cause dysfunctional closing patterns leading to misaligned jaw growth
Cause chewing or eating problems

Cause premature wear of the teeth
Cause gum disease including bone loss
Make your smile less attractive
Potentially be implicated in TMJ disorders

Treatment of posterior crossbite

If there is a single tooth crossbite, the tooth can be moved with braces into the correct position. In some cases, a retainer can be utilized. With multiple teeth in crossbite, the boney arch may need to be expanded with orthopedic appliances, braces and/or other intra-oral appliances.

Deepbite

The upper front teeth extend out over the lower front teeth. Deepbite relates to the excessive overlapping of top and bottom teeth. Deepbite is due to a disproportionate amount of eruption of front teeth or over development of the bone that supports the teeth.

Deepbite should be corrected because it can:

Cause improper functioning of your front teeth
Premature and uneven wear of the front teeth
Result in the lower front teeth biting into the gum tissue of the upper palate leading to tissue problems.
Cause jaw or joint problems

Make your smile less attractive

Treatment of deepbite

Deepbite can be corrected through moving the front teeth up and/or bringing the back teeth together, which will “open” the bite so the teeth are properly aligned and the deep bite is eliminated.

Openbite

An open bite exists when the upper and lower front teeth do not overlap. It may be caused by oral habits such as tongue thrust, digit sucking or when the jaws don’t grow evenly. Openbite may cause a number of unwanted habits, such as tongue thrusting. An openbite can cause eating problems, speech problems, and excessive wear of those teeth which do meet. An open bite can also be unattractive.

Treatment of openbite

Openbite can be corrected through growth modification of the jaws، extrusion of the front teeth using braces and in some cases surgical correction of the jaws. Also breaking oral habits, such as digit sucking, will facilitate the correction of an openbite.

Excessive overjet

Characterized by the upper teeth extending too far forward or the lower teeth not extending far enough forward. This can be caused by a skeletal imbalance of the upper and lower jaws; lack of coordination of the dental arches; flared upper incisors, missing lower teeth or a combination of all the above. In addition, oral habits such as thumb sucking, finger sucking or tongue thrusting can exacerbate the condition. The appearance and function of your teeth are impacted by this type of bite. This problem can be particularly unsightly, as the lips may not meet. There is an increased risk of injury to the front teeth with an excessive overjet, particularly if the patient plays contact sport.

Treatment of excessive overjet

Excessive overjet can be corrected through growth modification using a headgear, a functional appliance to reduce the skeletal imbalance. In adult patients, skeletal problems or discrepancies can be managed by camouflage orthodontics or by surgical jaw correction to treat the disharmony and give a more ideal functional and esthetic result.

Crowding

Crowding is a common orthodontic problem that happens when teeth have insufficient room to erupt from the gum. It can be unattractive and difficult to clean and may create problems with chewing and biting.

Treatment of crowding

Extra space can be created by expansion of the arches or extraction of teeth. Once space is created, braces will eliminate crowding and align the teeth. Correction of crowding can help prevent dental decay and periodontal disease by improving the ability to remove plaque from the teeth.

Spacing

Spacing, the opposite of crowding, is an excess of available space, resulting in gaps between the teeth. This generally occurs when the teeth are smaller than the available space. Protrusive teeth, missing or impacted teeth, or abnormal gum tissue attachments can also cause spacing.

Spacing should be corrected because it can:

Result in gum problems due to the lack of protection by the teeth
Prevent proper functioning of the teeth
Make your smile less attractive

Treatment of spacing

Moving the teeth together and properly aligning them within the jaws can close the spaces.

Misaligned dental midlines

The dental midline is the line between your two upper front teeth and your two lower front teeth, and it plays a significant role in orthodontic treatment. The dental midlines of your upper and lower jaws should align with each other in the center of your upper and lower arches. Those midlines also should align with the center of your nose and the midpoint between your eyes. When this doesn’t happen, the term applied to that condition is a “deviated” midline caused when the back bite does not fit and match appropriately, which may negatively impact jaw and proper dental function.

Treatment of misaligned dental midlines

If there is a dental origin, alignment of the crooked teeth may resolve the problem fully or partially. In cases with a skeletal origin, camouflage orthodontic treatment or orthognathic surgery may be indicated.