No two sets of teeth are the same. That goes for “perfect” smiles or those with misalignments. The types of malocclusions and severity range the gamut from insignificant to debilitating. If you’ve been diagnosed with a malocclusion, you may be wondering exactly what that means.
Read on to learn about types of malocclusion often treated by dentists and what they mean for your oral health.
What is Malocclusion?
The term “malocclusion” is based on the root word “occlusion,” which refers to the relationship of your top and bottom teeth when they’re in their “resting” position. Healthy occlusion doesn’t mean perfectly symmetrical contact of your teeth – it allows for a small amount of variance. However, when your bite is dramatically misaligned, it’s what orthodontists refer to as a malocclusion.
Malocclusion comes in many shapes and forms. For starters, not all malocclusion requires treatment. Despite being beyond the normal or healthy ranges of occlusion, malocclusions aren’t always a risk to your oral health or dental development.
While your general dentist will often identify malocclusion or the risk of future issues, an orthodontist is critical to evaluating and planning potential treatment. Malocclusions, like many dental health issues, are most easily treated earlier – which is why it’s important to have an orthodontic exam as early as age seven to avoid developmental problems!
One way different types of malocclusions are tracked is through classes. There are three classes of malocclusion, and they describe different types and severities:
Class 1 Malocclusion
The most common type of malocclusion, a class one is described by upper teeth overlapping the bottom teeth. To remain a class one, the bite needs to be normal and the overlap needs to be minimal. Not all class one malocclusions need treatment, and sometimes they’re more of an aesthetic issue than one that impacts eating or speech.
Class 2 Malocclusion
If the patient’s upper teeth and jaw extend past the lower teeth or jaw more significantly, it may be classified as a class two malocclusion. At this point, orthodontic treatment is recommended. The earlier a class two is treated, the better your chances are to avoid bone or tooth development issues associated with malocclusions.
Class 3 Malocclusion
Less common than class one or two, a class three type of malocclusion involves a significant underbite. Functionally, a class three malocclusion will affect speech, chewing and the development of the jawbone or teeth. Like class two, a class three malocclusion is highly recommended for orthodontic treatment – regardless of age.
Common Types of Malocclusion
This term applies to occlusion where the upper front teeth overlap the bottom teeth. Small overbites are common, and often can be left untreated. However, moderate to severe overbites can cause the lower teeth to actually bite into the roof of the mouth, or the upper teeth to bite into the lower gums. In either of these situations, the overbite should be treated to avoid complications.
If an overbite is when the upper front teeth overlap the lower teeth, an underbite is – as you probably guessed – when the lower teeth overlap the uppers. While overbites are somewhat common, underbites aren’t.
For people with underbites, the most common concern is aesthetic. An underbite can extend the chin in a way some might find unappealing. However, underbites, like many types of malocclusion, make it harder to chew, swallow or speak.
Unlike overbites or underbites, which are focused on the front teeth, crossbites refer to overlaps in the rest of your teeth. Sometimes crossbites are dominant to one side but can affect both at the same time. A crossbite can range from just the middle-to-rear teeth or include your front teeth too.
The main complications associated with crossbites are excessive tooth or gum wear and chewing. Depending on the severity of the crossbite, it can also lead to more extreme issues with jaw development.
Also referred to as dental crowding or just crowding, overcrowding is a type of malocclusion caused by too little space for teeth to properly fit in the mouth. When this happens, the teeth erupt and adjust into crooked positions or overlap.
Overcrowding is one of the most common types of malocclusion that lead a patient to an orthodontist. It causes several issues, which is why orthodontists typically recommend treatment:
- Increase in tooth decay
- Increased chances of gum disease
- Pain or discomfort
- Self-esteem concerns
- Chewing difficulty
- Speech problems
When teeth are overcrowded, they create traps for food and plaque that are nearly impossible to keep clean. Bacteria in your mouth leads to enamel erosion, decay and potential tooth loss.
Similar to overbites, overjets are when your upper teeth rest past your lower teeth but don’t make contact. In overbite scenarios, the teeth tend to angle in and press against the lower front teeth or gums, but overjet teeth will simply hang above them.
While this may sound like less of a problem, it’s actually a major health risk. Overjet teeth are at greater risk for damage from impacts or accidents. They cause more significant problems for chewing and speaking as well.
A smaller, but readily noticeable type of malocclusion is when the upper front teeth have a significant space between them. This is known as a diastema. They can happen to your teeth just as a natural result of growth, but often form through bad health habits like thumb sucking or “tongue thrust.” This is when the tongue is pressed against the teeth when swallowing, which can happen to older children or even adults.
Treatment isn’t necessary for diastema – as it’s primarily an aesthetic issue – though it’s commonly treated with braces. However, the underlying causes of diastema can be a concern for your dentist or orthodontist. If it didn’t form as you were going through growth spurts, it’s likely that bad dental habits or gum disease are the root causes.
Often confused with diastema, spacing concerns your whole set of teeth, versus just the front teeth. However, the causes of spacing can be similar:
- Tongue thrust
- Thumb sucking
- Lost teeth
- Small teeth
If you have spacing, it increases the chances of developing decay between the teeth and leaves your gums more exposed to bacteria. More commonly, it’s considered an aesthetic issue that children or adults would like corrected.
As the name implies, an open bite is a type of malocclusion where the teeth, when at rest, leave an open space directly into the mouth. Typically, the rear molars make contact, but the front teeth angle outward, leaving a gap.
Functionally, an open bite causes difficulty with eating and speech. Speech impediments like a lisp are more common with orthodontic issues like this. Additionally, the rear teeth being the only teeth that make contact can cause them to experience uneven wear versus your front teeth. This leaves the rear teeth more vulnerable to long-term damage and fractures.
Treatment Options for All Types of Malocclusion
If you have any type of malocclusion, an orthodontist will be able to help. Orthodontic treatment is different for every patient, from the time it takes to complete to the types of treatment appliances used. Here are the types of treatment options available, with most types of malocclusion allowing for some choice in which appliances can help.
- Traditional Metal Braces – A standard in orthodontics for decades, traditional metal braces use metal, wires and rubber bands to gently reposition your teeth. The technology has improved over the years, and they’re far more comfortable and effective than those you may be imagining!
- Ceramic Braces – While similar in function to metal braces, ceramic braces are a popular alternative due to their subtle appearance. Ceramic brackets match the color of most teeth to help them blend in.
- Lingual Braces – Also known as hidden braces, lingual braces are secured on the rear side of your teeth. This allows them to gently reposition your teeth without others seeing them.
- Invisalign – Easily the most popular type of braces, Invisalign aligners are clear and can readjust your teeth without metal, wires or rubber bands.
Just remember – while you may have a preference, your orthodontist may recommend or require one type of appliance versus another. No matter which appliance you end up using, the end goal will be a healthier, more aesthetically pleasing smile that you can enjoy for a lifetime!
Do you have questions about how to best take care of your braces? We can answer your questions to keep your teeth and gums healthy – schedule a free consultation! Contact us online or call 440-842-8015
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