Crowded teeth; Misaligned teeth; Crossbite; Overbite; Underbite; Open bite
Malocclusion means the teeth are not aligned properly.
Occlusion refers to the alignment of teeth and the way that the upper and lower teeth fit together (bite). The upper teeth should fit slightly over the lower teeth. The points of the molars should fit the grooves of the opposite molar.
The upper teeth keep you from biting your cheeks and lips, and your lower teeth protect your tongue.
Malocclusion is most often hereditary. This means it is passed down through families. It may be caused by a difference between the size of the upper and lower jaws or between the jaw and tooth size. It causes tooth overcrowding or abnormal bite patterns. The shape of the jaws or birth defects such as cleft lip and palate may also be reasons for malocclusion.
Other causes include:
There are different categories of malocclusion:
Symptoms of malocclusion are:
Most problems with teeth alignment are discovered by a dentist during a routine exam. Your dentist may pull your cheek outward and ask you to bite down to check how well your back teeth come together. If there is any problem, your dentist may refer you to an orthodontist for diagnosis and treatment.
Very few people have perfect teeth alignment. However, most problems are minor and do not require treatment.
Malocclusion is the most common reason for referral to an orthodontist.
The goal of treatment is to correct the positioning of the teeth. Correcting moderate or severe malocclusion can:
Treatments may include:
It is important to brush and floss your teeth every day and have regular visits to a general dentist. Plaque builds up on braces and may permanently mark teeth or cause tooth decay if it is not properly removed.
You will need a retainer to stabilize your teeth after having braces.
Problems with teeth alignment are easier, quicker, and less expensive to treat when they are corrected early. Treatment works best in children and adolescents because their bones are still soft and teeth are moved more easily. Treatment may last 6 months to 2 or more years. The time will depend on how much correction is needed.
Treatment of orthodontic disorders in adults is often successful, but may require longer use of braces or other devices.
Complications of malocclusion include:
Call your dentist if toothache, mouth pain, or other new symptoms develop during orthodontic treatment.
Many types of malocclusion are not preventable. It may be necessary to control habits such as thumb sucking or tongue thrusting (pushing your tongue forward between your upper and lower teeth). Finding and treating the problem early allows for quicker results and more success.
Dean JA. Managing the developing occlusion. In: Dean JA, ed. McDonald and Avery's Dentistry for the Child and Adolescent. 10th ed. St Louis, MO: Elsevier; 2016:chap 22.
Dhar V. Malocclusion. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 335.
Hinrichs JE, Thumbigere-Math V. The role of dental calculus and other local predisposing factors. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds. Newman and Carranza's Clinical Periodontology. 13th ed. Philadelphia, PA: Elsevier; 2019:chap 13.
Koroluk LD. Adolescent patients. In: Stefanac SJ, Nesbit SP, eds. Diagnosis and Treatment Planning in Dentistry. 3rd ed. St Louis, MO: Elsevier; 2017:chap 16.
Nesbit SP, Reside J, Moretti A, Gerdts G, Boushell LW, Barrero C. Definitive phase of treatment. In: Stefanac SJ, Nesbit SP, eds. Diagnosis and Treatment Planning in Dentistry. 3rd ed. St Louis, MO: Elsevier; 2017:chap 10.BACK TO TOP
Review Date: 2/6/2020
Reviewed By: Michael Kapner, DDS, Family and Cosmetic Dentistry, Norwalk, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2022 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.