Malocclusion is a seemingly trivial malady but one that causes great unhappiness to many.
Because your facial appearance exerts a great and largely hidden influence on your perceived attractiveness and personality and the teeth play a central role in your facial appearance.
What really is malocclusion?
The alignment of teeth is also known as occlusion and when there is a deviation from the ideal occlusion this misalignment is called malocclusion. Malocclusion is an official term which means non-alignment of upper and lower teeth in the dental arches.
In normal teeth alignment upper teeth are slightly forward of the lower teeth so that they slide in front of the lower teeth when you bite or when the jaw is closed. Also, when the teeth alignment is normal, the pointed projections (known as ‘cusps’) on the molar teeth are meant to align with the grooves or depressions in the opposite molar. When you have malocclusion this does not happen properly, leading to an abnormal bite.
What are the causes of malocclusion?
Inherited causes: genetic transmission of teeth abnormalities from one generation to the next.
Oral habits in children: such as thumb sucking, tongue thrusting, use of pacifiers after the age of three and prolonged usage of feeding bottles.
Other causes: these include early loss of teeth, improper dental fillings, gum and periodontal diseases, injuries of the jaw and tumors in the mouth.
How can we classify malocclusion?
Proper classification is essential to accurate diagnosis and treatment of malocclusion. It is primarily classified into three types which include the following:
Class 1 malocclusion: This is the most common type of malocclusion where the appearance of the face is normal, straight as well as the bite is normal. But the opposite molars are nonaligned. The occlusion take place at the mesiobuccal cusp of first permanent molar (maxillary) with mesiobuccal groove of first permanent molar (mandibular)
Class 2 malocclusion: Also known as retrognathism is the condition when upper and lower jaws and teeth are overlapped severely and mesiobuccal cusp of first molar(maxillary) lays between the first and second premolar (mandibular). This type of malocclusion has two sub-divisions depending on the anterior teeth’s position that includes:
Class 2 division 1: This type of malocclusion has a skeletal discrepancy between the maxillary and mandibular molars. In some people the maxillary first molar can be protruded or the mandible can be retrusive or both the cases and there can be the large overjet
Class 2 division 2: In this type the anterior teeth (maxillary) are retroclined and the existence of deep overbite (supraocclusion) whereby the lower teeth are completely overlapped by the upper incisors
Class 3 malocclusion: Also known as prognathism when the occlusion occurs in mesiobuccal cusp of first molar (maxillary) with the mesiobuccal groove of first molar (mandibular)
Class 3 malocclusion has 2 subdivisions as follows:
TRUE Class 3 malocclusion (SKELETAL): This condition is genetic in origin and caused when the lower jaw is disproportionately smaller or larger than the upper jaw.
PSEUDO Class 3 malocclusion: This condition is characterized by a forward movement of the mandible when there is a closure of the jaw (anterior crossbite)
What are the common complaints and symptoms associated with Malocclusion?
The most common complaint is a heightened self-consciousness about the appearance of the face. Typical symptoms include:
- Teeth are improperly aligned
- Difficulty in brushing and flossing the teeth which in turn leads to cavities and gum diseases
- Discomfort while biting or chewing
- Frequent unintentional bites of the inner cheeks and tongue
- Speech problems
- Difficulty in breathing through the nose
How can we detect or diagnose Malocclusion?
It is usually diagnosed on regular dental checkups. If discovered, dental X-rays are typically recommended by the dentist to check for the type and severity of the malocclusion.
How do you treat Malocclusion?
The treatment method depends on the extent of the malocclusion including the following:
Habit breaking appliances: Removable appliances should be used for children with thumb-sucking or any other oral habits that might cause unnatural pressure of the teeth as they are developing.
Fixed Appliances: This involves the use of orthodontic braces to reposition the teeth in order to correct the bite. It is an effective method to straighten the teeth and for the correction of the jaw position. Teeth have a tendency to move out of place so retainers are usually needed to keep the teeth in position once the braces have been removed.
Jaw surgery: This is used to correct malocclusion when the jaw bones are involved and to correct crowns and dental restorations which have been improperly performed. Jaw surgery is the only method for correcting a protruding mouth, often a symptom of malocclusion.
What are the complications associated with orthodontic treatment for malocclusion?
- Pain and discomfort while wearing dental appliances
- Speech difficulties
- Chewing problems
- Tooth decay
- Oral ulcers due to irritation of the gums and mouth caused by the appliances