Malocclusion of teeth is more technical way of saying that a person’s teeth are not properly aligned. “Occlusion” is a reference to the manner in which the upper and lower teeth fit together and are aligned, more commonly called the “bite.” Malocclusion means that the bite is somehow misaligned, to varying degrees. Edward Angle was the first to differentiate the different types of malocclusion based on the positions of the molars. For a bite to be considered “perfect,” the upper first molar rests in the lower first molar. Any deviation for this would affect the bite and considered to be a malocclusion. There are three different types of malocclusion. In this section, we will look at the most common of these: a Class 1 malocclusion.
What is a Class 1 malocclusion?
A Class 1 malocclusion is different in that the bite is considered “normal” by Edward Angle’s measures. The upper first molar is nestled comfortably in the lower first molar. The difference here lies in the position of the other teeth.
A Class 1 malocclusion may see teeth that are overcrowded or overlapping. Other teeth may be either under erupting or over erupting relative to each other. This means that some teeth are emerging in a very shallow way from the gum, while others are growing out to an extreme that can threaten their stability. These can force teeth into an overbite.
What causes a malocclusion?
Malocclusion has a variety of causes, each of which can contribute to its severity.
Bone structure
Some people are born with upper and lower jaws that don’t quite fit. The upper jaw may be smaller or larger than the lower. This can cause malocclusion.
Birth defects
Children born with cleft palate or lip may experience malocclusion as they develop, even if they have corrective surgery as infants.
Thumb sucking and extensive pacifier or bottle use
Perhaps the most common cause of any type of malocclusion is thumb sucking and pacifier or bottle use. Many infants self-soothe by sucking their thumbs, but for those children who continue to suck their thumbs as they grow, Class 1 malocclusion is very common. This is also common for children who rely on pacifiers and bottles as they grow out of infancy.
Growth of the teeth
Even without the influence of thumb, pacifier, or bottle, some people are born with teeth that erupt from the gums in a way that can influence the bite. Teeth may grow in sideways or may not come in enough. There may be too many teeth, resulting in overcrowding.
Sometimes baby teeth that are stubborn and don’t fall out naturally can result in two rows of teeth. These extra teeth can interrupt the bite and result in malocclusion.
What are the different malocclusion types?
There are three different types of malocclusion. Class 1 is the most common; the other two are:
- Class 2 malocclusion (also referred to as retrognathism or overbite): This malocclusion occurs when the upper jaw protrudes over the lower jaw. Although some overlap is normal, this type of malocclusion sees the lower teeth completely hidden by the upper teeth.
- Class 3 malocclusion (prognathism or underbite): The lower jaw pushes forward past the upper jaw, sometimes so much so that the upper teeth rest inside the lower teeth.
These three classes are the main and most common types of malocclusion, but there are two others that fall into these classes while still warranting a separate mention.
An open bite is when the front teeth do not connect, usually as a result of chronic and long-term thumb sucking or an anatomical structure that results in a longer face.
People with short faces and underdeveloped molars may also have something referred to as a deep bite. In this case, the lower incisors actually touch the gum tissue inside the upper jaw.
How can I tell if I have a malocclusion?
While it’s possible to visually diagnose most malocclusion of teeth, there are other symptoms. These include:
- Jaw pain
- Excessive and uneven wearing of teeth
- Speech issues
- Facial changes
- Difficulty eating
Jaw pain is pretty easy to understand, but let’s look at the other symptoms in more detail.
Excessive and uneven wearing of teeth
Different types of malocclusion can result in uneven wearing of teeth, both in the tooth enamel and in the tooth itself.
As this continues, teeth can be susceptible to cavity and other issues, such as cracks that can lead to tooth abscess.
Speech issues
As the bite worsens, the teeth can interfere with the tongue, affecting speech.
This can affect not only the development of speech in children but also cause slurring in adults.
Facial changes
As the Class 1 malocclusion of teeth gets deeper, the structure of the face can begin to change. As the upper jaw reaches forward, the chin may appear to recede and get smaller.
Difficulty eating
At its most extreme, people with any type of malocclusion may begin to have difficulty eating.
Biting with the front teeth becomes challenging, as teeth don’t come together properly, and uneven wear in the molars can make chewing tough foods (e.g., meats and uncooked vegetables) a chore.
People with malocclusion may also be forced to chew with their mouths open, which, while not a direct health risk, is not optimal.
What’s the best treatment for a Class 1 malocclusion?
As we have seen above, a Class 1 malocclusion can have effects that go beyond the cosmetic. Correcting malocclusion makes teeth easier to keep clean and eliminates the stress and strain in the jaw caused by an incorrect bite.
Treatment options depend on several factors, including the age of the patient and the severity of the malocclusion. In the case of overcrowding or teeth that are not coming in correctly, removal of those teeth may be called for. If this does not fix the malocclusion, your dentist may use an appliance or retainer to re-align teeth.
Braces, either traditional or Invisalign, are also commonly used to treat a malocclusion overbite. In extreme cases, surgery to lengthen or shorten the jaw may be necessary, but this is rare.
Contact your Scottsdale dentist, Dr. Janne Lynch, for a full evaluation of your bite and to see which treatment option will work best for you! Visit us at one of our locations in the Phoenix area.
