Crooked and Misaligned Teeth: How To Fix Crooked Teeth, Causes, and More

Crooked Teeth: Causes, Risks, and Treatments

Crooked teeth are common and can cause dental problems, functional impairment, or dissatisfaction with appearance. Let’s take a look at what causes teeth to become crooked, and what can be done to correct misalignment.


Key Takeaways

  • Crooked teeth are very common, and most cases are genetic.

  • Oral habits such as thumb sucking and poor nutrition may cause the problem too.

  • Crooked teeth may lead to difficulty chewing, gum disease, or low self-esteem.

  • Braces, retainers, and even surgery are the mainstays of conventional treatment.

  • Clear aligners are a more recent development, including at-home aligners administered by telehealth.


What Are Crooked Teeth?


Crooked teeth are a type of dental malocclusion, where the teeth are misaligned. Some people with crooked teeth only have one tooth out of place, while others may have several teeth or all of one or both jaws affected. Serious misalignment can cause pain or difficulty eating or speaking, but mild cases may be barely noticeable [1].  


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Causes of Crooked Teeth 

The main causes of crooked teeth are:

  • Malocclusion.
  • Jaw size.
  • Poor myofunctional habits.
  • Poor dental care.
  • Poor nutrition.
  • Genetics.
  • Injury to the face.



Some types of crooked teeth are known as malocclusions, and often involve a failure of upper teeth to meet lower teeth. The most common type involves the top teeth sitting slightly forward. With an overbite, your upper jaw is positioned forward over the lower jaw, while an underbite features your lower jaw in an extended position.


Approximately 56% of children worldwide have malocclusion with the majority (81%) residing in Africa


Jaw Size

A smaller jaw bone can make you more likely to develop crooked teeth. For this reason, women are more likely to have a crowded mouth than men. It was, however, once believed that wisdom teeth were the main factor behind lower front teeth crowding, but this has been disproven [2].


The biggest difference in arch perimeter between crowded and non-crowded teeth, was seen in the men’s group, suggesting that women in general have smaller jaws


Poor Myofunctional Habits

Habits such as thumb sucking, eating on one side only, and tongue thrusting can make teeth crooked as they erupt, through changing the mechanical forces on new teeth [3]

Myofunctional habits can even affect adult teeth. A case study of a man seeking orthodontic treatment for the second time described successful jaw and teeth straightening after sinus surgery and habit training, as difficult breathing shifted his teeth out of place [4]


Poor Dental Care

Poor oral hygiene, particularly if it leads to tooth loss, may lead to misaligned teeth. Baby teeth assist the eruption of permanent teeth by acting as guides, and support facial muscle and speech development. Early loss or extraction leads to a loss of this support. Dental care is most important during childhood, as enamel only completes its hardening after eruption [5].


In the US, it was found that approximately 13.2% of children have untreated dental caries


Poor Nutrition

Diets high in processed junk food may affect oral health by impairing bone development. Intake of fat-soluble vitamins is of particular importance. Vitamin D assists in calcium metabolism, for example, while vitamin A activates bone-breaking osteoclasts to remodel bones into their adult form. Vitamin K supports mineral transport into the bones [6]



The development of your jaw bone, muscles, tongue, cheeks, and even lips can affect the alignment of your teeth as they erupt. As genes play a major role in these developments, crooked teeth often run in families [1]


Injury to the Face

Injuries can not only break teeth, but push them out of their normal alignment. A study on young children found that just over one-quarter of teeth injuries led to luxation, or misaligned teeth [7]


Both preventable causes, including bad oral habits, and unavoidable causes such as genetics, can make children’s teeth crooked. 


Potential Issues Caused by Crooked Teeth 

Some issues that crooked teeth can lead to include:

  • Chewing and digestion issues.
  • Speech difficulties.
  • Excess wear.
  • Periodontal disease.
  • Self-esteem issues.


Chewing and Digestion Issues

If your teeth are crooked and do not meet properly, chewing may be difficult, particularly with small pieces of food. Tooth pain as a result of severe misalignment, an increased prevalence of tooth decay, or the teeth digging into your gums or lips causes even more problems with chewing. Among children, pain is linked to an over five times higher rate of difficulty eating and drinking [8]


Speech Difficulties

The positioning of your teeth influence the growth, development, and maintenance of your facial and jaw muscles, particularly in childhood. Additionally, issues such as pain can lead to flinching and guarding of your mouth, which affects speech even further. Children with tooth decay show a 14 times higher rate of speech difficulty for this reason [8]


Excess Wear

As they have less support around them, misaligned teeth are more likely to become damaged in cases of facial injury. Additionally, you may move your mouth in ways that wear your teeth down as a way to compensate for difficulties eating, or even grind your teeth [1]


Periodontal Disease

Severely crooked or crowded teeth may be more difficult to brush, which can lead to tooth decay and even gum disease. For example, severe crowding of the front teeth almost doubles the risk of gum disease, increasing rates by 93%.

Deep overbite in the front teeth, with contact between the gums, and front teeth crossbite increase the risk of gum disease by 40% and 75% respectively [9]


Self-Esteem Issues

Many people with misaligned teeth, particularly crooked permanent teeth, are unhappy with their overall appearance. Children and teenagers with crooked teeth are often teased, while adults may feel less confident when speaking in front of others. 


Left untreated, misaligned teeth can lead to problems ranging from gum disease to dissatisfaction with the appearance of your smile. 


Can Crooked Teeth Be Prevented? 

Some cases of crooked teeth can be prevented, particularly if you start before your child’s baby teeth come in. Thumb sucking, tongue thrusting, sucking or biting the lips and cheeks, and chewing on one side of the mouth can affect how straight baby and adult teeth are when they erupt [3]


How To Correct Crooked Teeth

Different types of braces, aligners, retainers, and even surgery can be used to rectify crooked teeth.



Traditional metal braces are the “classic” treatment for straightening crooked teeth. In fact, they were the only orthodontic treatment for this purpose for many years. Metal braces are made of brackets adhered to your teeth, and arch or flexible wires that hold them together. These are tightened at each appointment to continue the teeth straightening process. 

Sometimes, metal ties or rubber bands are added to put more pressure on the teeth to move them into the correct position. 

Traditional braces are the most effective of your treatment options. If you don’t like their appearance but need to use them, ceramic braces are a barely-visible alternative to all-metal brackets [10]


Lingual Braces

Lingual braces are a type of “invisible” braces, as they are placed on the inner side of your teeth. They are the most effective type of braces besides traditional brackets, but are more time-consuming to apply [11]


Clear Aligners

Clear aligners can be effective treatment options in crooked teeth and milder cases of underlying causes such as malocclusion. Research shows they are also generally faster at straightening teeth [12]

Some clear aligner brands allow for orthodontic treatment at home, which is often cheaper and expands access to areas without in-person providers. While the American Dental Association advises against clear aligners, they can still be effective. 

Byte aligners are designed with the principles and practices of cosmetic dentistry to improve your smile. After completing an at-home impression kit, a specialist orthodontist will design a series of aligners that gradually straighten teeth through mechanical force. They can straighten crooked teeth effectively in mild cases of misalignment and malocclusion. 

AlignerCo is one of the most affordable aligners available. Unlike Byte, teenagers can qualify for treatment as long as they have no baby teeth remaining. However, personalized support is more sparse, which may contribute towards the lower costs. 

To learn more, read the complete Byte Aligners review and AlignerCo review here. 


Byte aligners can straighten teeth in as little as 6 months 


Fixed Retainers

Wearing a removable or fixed retainer is typically necessary to prevent orthodontic relapse. This is where your teeth return to their original misalignment. Sometimes, your treatment plan will recommend a nighttime aligner, including Byte aligners. You may even need a fixed retainer for months or years after braces, which cannot be removed [1]. 



Surgery may be necessary if your teeth are crooked due to bone malformations. A procedure known as an osteotomy is commonly used for severe malocclusion. Here, your surgeon cuts into the gums behind your top teeth or bottom teeth, depending on where the issue lies. This allows for the jaw to be brought forward or back, and reset with titanium screws or plates.


There are treatments to straighten teeth indicated for all levels of severity, from clear aligners for mild cases to surgery for severe misalignment.


Is It Necessary To Correct Crooked Teeth?

Not every case of crooked teeth needs to be corrected, as many do not cause issues such as pain or difficulty chewing or speaking. However, if you are insecure about your appearance or your teeth are causing issues, you can choose to have your teeth straightened. 


What To Expect When You Visit Your Dentist or Orthodontist

If you or your child has crooked teeth, you will need specialized orthodontic treatment. Your orthodontist will first perform a visual oral examination, including whether you can open and close your mouth correctly. They will likely ask questions about potential causes too. 

Your orthodontist will take X-rays of your mouth and dental casts, which are impressions of your top teeth and bottom teeth. Digital scanning is used by some professionals. Then, your orthodontist creates a treatment plan, including how long you need braces, how they will be positioned, other interventions, and realistic treatment goals [1].



What do we need to know about having crooked teeth?


Is Crooked Teeth Normal?

Can I Just Straighten My Bottom Teeth?

How Much Does It Cost To Straighten Bottom Teeth?

Can You Fix Really Crooked Teeth?



Crooked teeth are a common issue, and often don’t cause significant health impacts unless the crowding is severe. Your genes’ influence on bone development, alongside oral habits and potentially nutrition, affect jawbone growth and teeth placement, so only some cases are preventable. 

Regardless of whether your misalignment could have been prevented, there are effective treatments available. Braces, retainers, and now clear aligners such as Byte, can give you the smile you’ve always wanted. 


Byte aligners are FDA-approved, affordable clear aligners 



  1. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Misaligned teeth and jaws: Overview. 2020 Jan 16. Available from:
  2. Stanaitytė, Rūta et al. “Do wisdom teeth induce lower anterior teeth crowding? A systematic literature review.” Stomatologija vol. 16,1 (2014): 15-8.
  3. Zou, Jing et al. “Common dental diseases in children and malocclusion.” International journal of oral science vol. 10,1 7. 13 Mar. 2018, doi:10.1038/s41368-018-0012-3
  4. Gracco, Antonio et al. “Multidisciplinary correction of anterior open bite relapse and upper airway obstruction.” Korean journal of orthodontics vol. 45,1 (2015): 47-56. doi:10.4041/kjod.2015.45.1.47
  5. Lynch, Richard J M. “The primary and mixed dentition, post-eruptive enamel maturation and dental caries: a review.” International dental journal vol. 63 Suppl 2 (2013): 3-13. doi:10.1111/idj.12076
  6. Lin, Steven. “Crooked teeth and nutrition: A surprising link.” Ortho Town. December 2017,
  7. Makeeva, I et al. “Prevalence of primary tooth traumatic injuries among children in a large industrial centre of Russian Federation.” European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry vol. 15,5 (2014): 341-5. doi:10.1007/s40368-014-0121-4
  8. Clementino, M A et al. “Association between oral conditions and functional limitations in childhood.” Journal of oral rehabilitation vol. 42,6 (2015): 420-9. doi:10.1111/joor.12273
  9. Bernhardt, Olaf et al. “New insights in the link between malocclusion and periodontal disease.” Journal of clinical periodontology vol. 46,2 (2019): 144-159. doi:10.1111/jcpe.13062
  10. Russell, J S. “Aesthetic orthodontic brackets.” Journal of orthodontics vol. 32,2 (2005): 146-63. doi:10.1179/146531205225021024
  11. Huh, Heidi H et al. “Practice of lingual orthodontics and practitioners' opinion and experience with lingual braces in the United States.” Journal of clinical and experimental dentistry vol. 13,8 e789-e794. 1 Aug. 2021, doi:10.4317/jced.58328
  12. Ke, Yunyan et al. “A comparison of treatment effectiveness between clear aligner and fixed appliance therapies.” BMC oral health vol. 19,1 24. 23 Jan. 2019, doi:10.1186/s12903-018-0695-z


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