Malocclusion: Getting the Bite Right

What causes misaligned teeth? Our ancestors' jaws were much larger, which made for a more ideal bite – or occlusion. There used to be more space in the mouth with plenty of room for the teeth, including the wisdom teeth. But due to dietary and genetic changes, jaw sizes have shrunk over time and today, one in five people have some sort of malocclusion where their teeth don't line up correctly, according to Science Daily. Some misalignments are minor and do not need correcting, but many cases require a referral to a specialist in order to achieve the perfect smile.

What is Malocclusion?

The term refers to any type of irregular contact between the upper and lower teeth. It can manifest as an overbite, open bite, under bite or cross bite. Your dentist will evaluate your occlusion at your dental visits and make recommendations for treatment, if necessary. Proper alignment allows for effective chewing and distribution of biting forces equally over all the teeth. If this balance is not ideal, over time malocclusion can lead to broken teeth and even tooth loss. There are several causes of malocclusion, including:

  • Mismatch between jaw size and size of teeth
  • Thumb sucking or tongue thrusting habit
  • Premature or congenital loss of or missing teeth

There are three categories of malocclusion. Class I is where the teeth may have spaces between them, are rotated or are crowded in addition to the upper and lower jaw not meeting properly. In Class II, the most common type, the lower jaw, or mandible, is too far back causing an overbite and a poor molar relationship. Lastly, in Class III, the lower jaw actually protrudes, causing an underbite where the lower teeth close in front of the upper teeth. Left untreated, it can lead to tooth damage and difficulties with speaking and chewing. Additionally, this improper bite can cause problems in the temporomandibular joint (TMJ), causing pain and difficulty chewing.

Malocclusion Treatment

In most instances, treatment involves orthodontics, including options like braces. Braces are usually used in childhood or early adolescence when the jaws are still developing and growing. However, it is never too late to seek treatment and orthodontists are trained to treat both children and adults. Treatment is often in phases and sometimes requires extraction of baby or even permanent teeth. In very rare cases, surgery may be necessary, especially in Class III instances. This orthognathic procedure is done by a maxillofacial surgeon to shorten the lower jaw to allow proper alignment of the teeth.

Throughout any type of treatment, proper care of the teeth and mouth, like brushing and flossing, are required for the best results. With braces, brackets are attached (bonded) to the teeth, and wires and elastics are connected to the brackets to correct alignments. These additions to your smile, however, can create significant challenges to keeping the teeth clean and healthy. Your dentist or orthodontist will recommend a fluoride treatment, like Colgate® Gel-Kam Preventative Treatment Gel, to help fight decay and decalcification.

Regular visits to your dentist and dental hygienist will help you diagnose any upcoming occlusion problems with your teeth and other underlying habits that will interfere with a healthy smile. And even if you're an adult, it's never too late to address the issue of an improper bite. Dentists and orthodontists are trained to give you a beautiful, healthy smile at any age.

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Top Oral Care Tips Related to ADULT ORTHODONTICS

  • Flossing – creating a flossing routine is important during orthodontic treatment. Orthodontists and hygienists may recommend interdental brushes or floss threaders to make getting in between teeth easier.

  • Brushing routine – using fluoride toothpaste and a soft-bristled toothbrush are ideal for cleaning teeth with braces. Begin brushing at a 45-degree angle at the gum line using small circular motions. Then place the toothbrush on top of the brackets, angling down to brush on top of each bracket. Finally, reposition the brush to brush the bottom of the bracket as well as the wire, angling the toothbrush up.

  • Fluoride mouthwash – after brushing and flossing, rinse with a fluoride mouthwash to help prevent cavities and white spots.

  • Mouthguards – wear a mouthguard if you play sports. Mouthguards can protect your cheeks and lips from serious cuts and can prevent damage to your braces or orthodontic appliance if you fall down or are hit in the face.

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