Misaligned Jaw and Treatment Options

When the upper and lower teeth don't meet comfortably the cause is a misaligned jaw. Two of the most noticeable types of jaw misalignment are overbite, where the upper teeth protrude, and underbite, where the lower teeth sit in front of the upper teeth. Dentists and orthodontists provide a range of treatment options, but generally the process can take a year or longer to correct the condition.

Living With a Misalignment

The effects of jaw misalignment are physical and emotional. When the condition is severe it can interfere with eating, breathing, sleeping and speech, and cause discomfort and pain even when the jaw isn't moving. This is because the joint where the upper and lower jaw meet is complex, and when it isn't able to function properly, chronic pain is often the result. Children with misaligned jaws can encounter teasing from their peers, and even if they don't, their underbite or overbite may make them self-conscious. Dentists and orthodontists call a mismatched bite "malocclusion," and the treatments include orthodontic work, cosmetic dentistry and surgery, depending on the severity of the malocclusion.


According to MouthHealthy.org, braces is the standard treatment for crooked or crowded teeth and a misaligned jaw. The traditional treatment is to cement brackets to the teeth and connect them with a wire. At regular intervals, usually over one to three years, an orthodontist tightens the wire, which gradually moves the teeth and jaw into alignment. Braces are often the go-to treatment for an overbite, where the upper jaw sits too far forward and the upper teeth protrude.

Headgear Braces

When the jaw misalignment is too excessive for regular braces to achieve a satisfactory result, the orthodontist may use headgear braces. Retraction headgear moves the upper jaw back, and protraction headgear moves the upper jaw forward. Both kinds of braces are fixed with internal and external wires and a strap or two straps that fit over the head and neck. Headgear braces are worn 12 to 14 hours a day.

Upper Jaw Expander

An upper jaw expander corrects underbite, where the lower jaw protrudes and the lower teeth are in front of the upper teeth when the mouth is closed. The upper jaw expander is a wire frame device that fits across the upper palate. The patient widens the expander a tiny amount every night, using a special key. After about one year, the upper jaw widens to correct the misalignment.

Reverse Pull Face Mask

Another device to correct an underbite, the reverse pull face mask looks similar to headgear braces and is also worn overnight. The orthodontist fixes metal braces to the upper back teeth, and these attach to the face mask, which wraps around the head and pulls the upper jaw back.

Cosmetic Dentistry

A jaw misalignment treatment option open to adults who have a mild condition is cosmetic dentistry. In some cases a dentist can reshape the lower teeth and apply veneers to the upper teeth. This doesn't fix the jaw misalignment, but it can make it less noticeable and allow the lower teeth to rest behind the uppers when the mouth is closed.

Jaw Surgery

In severe cases of jaw misalignment, orthognathic jaw surgery may be needed. An oral and maxillofacial surgeon uses fixes plates, screws and wires to the jaw to correct the problem. Surgery is usually only recommended where the misalignment affects everyday functions such as eating, speaking and sleeping.

Oral Care During Treatment

Reaching around orthodontic devices to clean the teeth can be challenging, but brushing twice a day with a fluoride toothpaste and flossing once a day offers the best chance of healthy, cavity-free teeth once treatment is over. Rinse once a day with Colgate Total® Advanced Pro-Shield , an antibacterial mouthwash that provides extra protection for teeth by reducing bacteria and plaque.

Jaw misalignment can be a serious condition, but it can be permanently fixed. With so many treatment options available, there's no need to miss out on having a well-aligned jaw and straight, beautiful teeth. Talk to an orthodontist to find out the best option for you.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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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.