Misaligned Teeth (Malocclusion): Understanding the Problem and Treatment Options
Misaligned teeth, also known as malocclusion, can significantly impact both your smile and oral health. This common issue encompasses various problems, such as crowded or crooked teeth, insufficient room for all teeth to erupt, and misalignment when biting down. It's important to note that approximately 75% of people experience some degree of malocclusion [^1].
The consequences of misaligned teeth can be diverse and may include uneven tooth wear, enamel damage, increased susceptibility to gum disease due to difficulties in maintaining oral hygiene, tooth decay, trouble chewing or biting food, speech problems, jaw pain, and mouth breathing [^2]. The severity and type of malocclusion can vary, and treatment options range from braces to surgery.
Types of Teeth Misalignment
Several types of malocclusion exist, including:
Overbite: The upper front teeth excessively overlap the lower teeth or come out at an angle, often referred to as "buck teeth."
Underbite: The lower teeth protrude in front of the upper jaw, opposite of an overbite.
Crossbite: The teeth tilt towards the cheeks or tongue, preventing proper alignment with the teeth in the opposite arch.
Open bite: When biting down, there is a noticeable space between the upper and lower teeth.
Overcrowding: Teeth are excessively crowded, causing some teeth to erupt at odd angles.
Spacing: Teeth are spaced too far apart, and a gap between the upper front teeth is called a diastema.
10 Causes of Misaligned Teeth
Understanding the underlying causes of misaligned teeth can help shed light on potential prevention strategies. Here are ten common causes:
Size mismatch between the jaw and teeth: The most frequent cause of misaligned teeth is a small jaw relative to the size of the teeth. Even a slight mismatch can lead to overcrowding and misalignment as the teeth seek the path of least resistance during eruption [^3].
Habitual thumb-sucking: Chronic thumb-sucking in children can result in misalignment. Similarly, repeatedly pushing the tongue against the front teeth can cause similar issues.
Lost teeth: If a tooth is lost and not replaced with an implant, denture, or bridge, the surrounding teeth may shift to fill the gap, leading to misalignment.
Congenital anomalies of the jaw: Certain jaw problems present at birth, such as cleft palate, can cause misaligned teeth. In these cases, the teeth often push forward and do not align properly [^4].
Trauma to the face or head: Injuries to the face or head can damage the bones and tissues supporting the teeth, potentially resulting in misalignment [^5].
Tumors or growths in the mouth: The growth of tumors or other abnormalities in the mouth can displace teeth, causing misalignment.
Teeth grinding (bruxism): Consistent teeth grinding or clenching can gradually push teeth out of their proper position, leading to misaligned bites and temporomandibular joint issues.
Medical conditions: Certain medical conditions, such as Down syndrome and Turner syndrome, can cause abnormal jaw growth during fetal development, leading to malocclusion.
Lack of dental care: Without regular dental care, issues like gum disease and cavities can contribute to misaligned and crooked teeth. Regular dental check-ups are essential for early detection and intervention.
Poor nutrition: Insufficient intake of essential vitamins and minerals can impact dental health, including tooth alignment. For example, vitamin D deficiency can affect bone strength and lead to misaligned teeth.
How to Fix Misaligned Teeth
The appropriate treatment for misaligned teeth depends on factors such as the severity of the malocclusion, age, and skeletal development. Dentists may need to administer treatment in multiple stages in some cases. Common treatment options include:
Braces: Dental braces consist of brackets bonded to the teeth, connected by wires and elastic bands. They gradually exert forces on the teeth to shift them into proper alignment. Once the desired alignment is achieved, braces are removed, and retainers are worn to maintain the results. Initially, the retainer is typically worn 24 hours a day, gradually reducing to nighttime wear for 2 to 3 years.
Clear aligners: Custom-made clear plastic aligners, similar to retainers, are used to progressively move the teeth into alignment. These aligners are replaced periodically, each one facilitating movement of up to 0.3 mm. Retainers are required after aligner treatment to prevent teeth from shifting back [^3].
Tooth removal: In cases of severe overcrowding, a dentist may recommend removing one or more teeth. This creates additional space for the remaining teeth to align properly. Tooth removal may be performed before braces or aligner treatment.
Surgery: Surgical correction may be necessary for jaw anomalies or improperly healed fractures. The procedure involves repositioning bones with screws and plates. Surgery may be combined with braces or other treatments.
Can You Prevent Teeth Misalignment?
While preventing teeth misalignment entirely may not be possible in all cases, there are measures that can reduce the risk. Consider the following preventive actions:
Encourage children to avoid thumb-sucking.
Limit or avoid pacifier use.
Wear a mouthguard when participating in sports.
Use a special mouthguard at night if you grind your teeth.
Address any underlying conditions that contribute to jaw anomalies.
Maintain regular dental check-ups to detect and address issues early.
Summary
Misaligned teeth, or malocclusion, can result from various factors, including thumb-sucking, premature tooth loss, and jaw anomalies. Treatment options range from braces and clear aligners to surgery. Although complete prevention may not be possible in all cases, taking preventive measures and visiting the dentist regularly can help maintain oral health and identify issues early on.