Misaligned teeth can be both inconvenient and unsightly. Unfortunately, even minor misalignments may require years of treatment to correct. Find out what the most common types of misalignment are, how to identify them, and potential treatment options.
Teeth misalignment occurs when the top and bottom teeth don’t meet cleanly, making biting difficult, among other problems.
Overbite may be the most common type of misalignment, while underbite might be considered the most serious.
Misaligned teeth are the result of genetics, as well as behavioral and environmental factors that affect childhood development.
Symptoms of misalignments can include an atypical appearance, difficulty biting, or excessive mouth breathing.
A more technical classification breaks misalignments, or malocclusions, into three categories according to severity.
An orthodontist is required to treat misalignments, and may use braces, veneers, or even surgery.
Misalignments can be minimized if development during childhood is guided in a healthy way.
Properly aligned teeth don’t just look better, they also chew more efficiently and are easier to care for [1]. Misaligned teeth, on the other hand, can cause a number of significant problems, from a higher risk of tooth decay and gum disease to joint pain and self-esteem issues [2]. More technically known as malocclusion, jaw and teeth misalignment is divided into several types:
Correcting misalignments starts with seeing a dentist, though orthodontic treatment is often required. It’s possible to suffer from more than one sort of misalignment.
Overbite, sometimes confused with overjet, is when the upper front teeth and jaw severely overlap the lower teeth. A certain amount of overlap is common and not a major problem. More significant overbite can cause teeth to dig into gums or make eating difficult.
A small overbite is about 2 to 4 millimeters, meaning there is that much overlap between upper and lower front teeth.
Scientifically called prognathism, underbite can be a more serious concern than overbite. The lower front teeth and jaw project further than the upper teeth, giving a bulldog-like look to the face.
While ‘crooked teeth’ can describe most misalignments, the term usually focuses on the way the faces of the teeth meet. Generally, lower and upper teeth should fit together evenly. Teeth are crooked when they don’t fit together well. It’s possible to correct crooked teeth with orthodontic treatment. That sort of treatment at a young age may also help prevent crooked teeth.
When teeth are spaced so close together they overlap and push each other out of place, they are crowded teeth. This can be caused by an underdeveloped jaw and smaller mouth. It’s even possible to have extra teeth, a condition called hyperdentition [3].
In a study, 0.72% presented with hyperdontia (hyperdentition). However, it was more common in men (0.73%) than women (0.69%)
Excessive spacing means too much space between teeth, so biting is difficult. It can be caused by missing teeth, either due to tooth loss or genetics.
Open bite refers specifically to how the front teeth, the incisors, meet. If they don’t overlap, it can be difficult to bite into food, causing overbite. The upper molars and lower molars might otherwise meet correctly.
Crossbite is caused by a misaligned jaw. The centerline of the upper jaw and lower jaw should meet in a correctly aligned jaw. If they are misaligned, there is crossbite.
Summary:
Crooked teeth are less efficient because the chewing surfaces don’t meet correctly. This can cause many problems, including wider health issues. There are several types of misaligned teeth. Overbite may be the most common, while underbite is usually considered the most serious.
A number of factors can contribute to teeth misalignment, both genetic and functional. If your parents have crooked teeth, you’re more likely to as well. Some genetic conditions like cleft lip can also cause misaligned teeth. However, both behavioral and environmental factors also can contribute to crooked teeth [4].
Behavioral factors:
Environmental factors:
Particularly in early childhood, the development of a child’s teeth can be shaped by strain placed on jaw muscles. Inflamed airways due to allergies or illness can also contribute. The way baby teeth develop influences the shape of gums and how permanent teeth come in, so that early issues continue to have an effect [5].
Generally, if you don’t notice your crooked teeth being a problem, you’re probably fine. However, even a small amount of misalignment can have an impact on your dental health. Tooth misalignment can lead to an increased risk of cavities, tooth decay, and periodontal disease, requiring additional dental care. Serious misalignments of teeth and jaw may obvious, including:
Summary:
Genetics affect the development of misaligned teeth. Behavior like thumb-sucking can also make crooked teeth more likely, as can some environmental factors. Symptoms of misaligned teeth include difficulty chewing and speech difficulties.
The types of misalignments we’ve discussed are helpful for understanding how the teeth are misaligned. Your dentist may use a different scale, one which measures the potential severity of the misalignment and the effects it could have on your mouth.
The most common type of misalignment, Class I Malocclusion is basically a degree of overbite, with the upper front teeth slightly overlapping the lower.
Class II is a more extreme version of Class I, with the upper jaw and teeth overlapping the lower. This type of teeth misalignment is also sometimes called retrognathism.
Class III is the most serious form of malocclusion. Also called prognathism, Class III is a more or less serious case of underbite, with the lower front teeth and jaw overlapping the upper. The upper jaw size may sometimes be underdeveloped. It can cause speech disorders, psychological issues, as well as complicated dental care.
Class III malocclusion can also cause temporomandibular joint disorder, which can make biting and chewing painful, among other issues. The misalignment may be addressed with headgear, though in extreme cases orthognathic surgery may be necessary to correct jaw alignment.
Summary:
Medically, malocclusions are divided into three classes of severity. Class I is the least serious, characterized by a degree of overbite. Class II is a more serious overbite. Underbite is categorized as Class III, the most serious type.
The first step to addressing a misalignment of your teeth is to see your dentist, who can help you select a treatment option. A misalignment may not need to be addressed if it’s not serious. Treatment may be most effective when adult teeth are still developing. Treatment options include:
Wearing braces may be the most common treatment, though clear home aligners are becoming popular.
If you ever suffered through “metal mouth” as a kid, it was because you had some sort of crooked teeth. Orthodontic treatment, typified by metal braces, is all about moving teeth into better alignment. Fixed braces use brackets and metal wires, fixing them to one tooth to pull other teeth into place.
There are several varieties of dental braces. Ceramic brackets are less visible, while lingual braces are hidden on the tongue-side of your teeth. Waiting for adult teeth to come in is common, though sometimes straightening baby teeth can help with the alignment of adult teeth.
Unlike traditional braces, clear plastic aligners are less visible and can be removed. Several services offer them by mail, so you receive treatment without leaving your home. Check out our Byte Aligners review and AlignerCo review for a closer look at some options.
Unlike fixed braces, aligners are not approved by the American Dental Association or Association of Orthodontists. However, they have been effective at straightening less crooked teeth, particularly straightening the front teeth.
Veneers are a treatment for crooked teeth in the front of the mouth. Typically, they are a layer of material placed over the outer face of the tooth. In addition to their aesthetic use, they can also be used in some cases to reshape a tooth for better alignment with ceramic laminate veneers.
Dental implants are used to replace missing teeth. Whether they were lost or never developed, adding a tooth can sometimes prevent spacing or misalignment. The implants used in the treatments often need to be custom-made to fit the patient [7].
Jaw misalignment sometimes can’t be addressed by orthodontic treatment alone. In the case of severe misalignments, particularly prognathism or underbite, surgery may be needed.
Summary:
There are a number of treatments available for misaligned teeth. The simplest may be clear aligners, though they are only suitable for minor issues. Braces are the most common treatment, but truly severe misalignment may require surgery.
There are a range of treatment options for correcting misaligned teeth. It’s difficult to say how much such treatment would cost, as it depends on the degree of severity, as well as other factors. Traditional braces cost about $6000 to straighten permanent teeth. Aligners like Byte are less expensive, costing around $2500 [8].
Like the cost, the length of orthodontic treatment can vary a great deal. Clear home aligners claim they can correct small issues, particularly with the front teeth, in less than a year. More serious issues that require treatment with braces can take between three and four years total. Treatment times can extend even further.
It may not be possible to completely avoid teeth misalignment, as genetics does play a role. However, preventing a few bad habits, along with timely orthodontic treatment, may help keep it to a minimum. Ideally, things like thumb sucking in young children is discouraged and breathing problems are addressed to prevent excessive mouth breathing.
An orthodontist may enter the picture as early as 6 years old [9]. However, a popular treatment option is to wait until 12 or 16 for braces, when baby teeth have been lost but jaw growth is still underway.
Here are some direct answers to common questions.
A lot of people have experienced firsthand how uncomfortable braces are to wear, between the discomfort and limitations they impost. However, correcting misaligned teeth is about more than an attractive smile. Suffering a little bit as a kid may have saved you a lot more discomfort later in life.
