Types of dental malocclusions
Type | Description | Causes | Consequences |
|---|---|---|---|
Crowded teeth | Teeth do not have enough space; leads to them overlapping, twisting or nesting. | Genetics or premature loss of milk teeth; wisdom teeth growing without space | Difficult dental care, higher risk of tooth decay; aesthetic impairment |
Gaps between teeth (diastema) | Teeth are too far apart because of a large jaw or missing teeth | Congenital excess space in the jaw; Habits such as thumb sucking or tongue thrusting | Aesthetic problems that cause gaps; impairment of speech development (e.g. lisping) |
Deep bite | The upper incisors cover the lower teeth excessively. | Genetic predisposition and growth disorders; incorrect biting habits | Wear of the lower incisors; pain in the jaw joint, gum problems |
Open bite | Upper and lower incisors do not touch, even when the mouth is closed. | Thumb sucking; use of pacifiers in early childhood; tongue thrusting | Impairment of speech development, difficulty chewing |
Crossbite | Upper teeth do not properly overlap the lower ones, but are offset inwards or outwards. | Uneven growth of the upper and lower jaw; one-sided chewing | Asymmetrical facial and jaw development, problems in the temporomandibular joint |
Overbite (prognathism) | Upper incisors far forward and slightly overlapping, | Genetic predisposition; thumb sucking; malformation of the jaw | Risk of injury to upper incisors; difficulty biting; speech problems |
Underbite (retrognathism) | Lower teeth further forward than the upper ones. | Genetics; disorders in jaw growth; misalignments because of unfavorable habits | Difficulty chewing and speaking; aesthetic impairment |
Causes of misaligned teeth
1) Genetic predisposition
Misaligned teeth often come from the parents. If parents had crooked teeth or other abnormalities, the children are likely to be affected too. If the jaw is too small, teeth do not have enough space to arrange themselves. This can lead to rotation or overlap of one or more teeth.
Typical examples for the wrong alignment of teeth are a jaw that is too large in comparison to the size of the teeth. Congenital malformations such as cleft lip and palate can also be inherited.
2) Early loss of milk teeth
Milk teeth are important because they make room for the permanent teeth. If you lose them too early, the neighboring teeth can migrate into the resulting gap. This often leads to a lack of space and misalignment of the permanent teeth later on and shifting teeth.
Possible consequences are crowding of the permanent teeth, displacement, and problems with jaw development.
3) Thumb sucking and pacifier use
Thumb sucking or using a pacifier after the age of three can affect the growth of the jaw. This can also affect the position of the teeth so that teeth are not properly aligned.
The pressure from the thumb or pacifier can tip the upper incisors forward. The shape of the jaw can change, especially the upper jaw can narrow. The lip closure can also be disrupted. All this affects the natural development of the teeth.
4) Malfunctions of the tongue and lips
If the tongue is in the wrong position when swallowing or speaking, this can lead to misalignment of the teeth. This often occurs in children who press their tongue forward against the incisors when swallowing (tongue thrusting).
In most cases, the incisors will move forward and speech development will be impaired (e.g. lisp). In these case your dentist may refer you to an orthodontist.
5) Jaw misalignment because of external influences
In addition to genes, external influences also play a role that can affect the development of teeth. Children who breathe primarily through their mouths (e.g. because of enlarged tonsils) tend to have jaw misalignments.
If children always chew on one side, this can lead to uneven jaw development. Falls can also affect growth and cause misalignments.
Angle classes of tooth misalignments
The Angle classification classifies tooth and jaw misalignments. The American orthodontist Edward H. Angle developed this system in 1899.
- Class I (neutral bite / normal bite with misalignments): the first upper and lower molars are in a normal relationship. However, misalignments can still occur.
- Class II (distal bite / overbite): the upper jaw is further forward in relation to the lower jaw. This often causes the upper incisors to protrude significantly.
- Class III (mesial bite / underbite): lower jaw is further forward than the upper jaw. This means that the lower incisors are in front of the upper ones.
Conclusion: Treatment options
Misaligned teeth are common and can cause aesthetic and functional problems. Crooked teeth are harder to clean and some misalignments affect the pronunciation of certain sounds. Therefore, these cases require treatment. However, modern dentistry offers options and orthodontic treatments to correct misaligned teeth:
- Fixed and removable dental braces
- Aligners (e.g. Invisalign in Turkey)
- Orthodontic surgery
- Fitting dental fillings, crowns