The Usual Suspects

When a person’s teeth or jaws don’t fit together properly and their bite is off, it’s known as malocclusion. Orthodontic treatment is usually the only way to fix the problem. If left untreated, malocclusion can cause speech and chewing difficulties, premature wear of the teeth and protective enamel and even increase the odds of dental injuries. Receiving the correct diagnosis is the first step in a successful treatment plan and while everyone’s mouth is different, these are the most common types of malocclusions we see:

Underbite

An underbite is characterized by a lower jaw that extends too far out. This causes the lower front teeth to sit outside of the upper front teeth. It can lead to problems ranging from chewing and speaking difficulties to sleep apnea depending on the severity.
Treatments: It’s really important to get a jumpstart on treating an underbite. If we catch it early while the jaw is still growing, we can use special appliances to guide and advance the growth of the upper teeth and jaw. If a patient waits until adulthood to address an underbite, they may require surgery to achieve the results they want.

Crossbite

A crossbite occurs when the upper teeth are positioned inside of the lower teeth either in the back (posterior crossbite) or the front (anterior crossbite). Patients will usually compensate by moving their lower jaw forward or to the side, which can create a whole host of problems including facial asymmetry and permanent changes in jaw growth.
Treatments: For an anterior crossbite, we can usually whip the teeth into shape with braces or Invisalign. If we’re dealing with a posterior crossbite, we often expand the upper jaw and then follow up with braces or, sometimes, Invisalign.

Upper Front Teeth Protrusion

This is a fancy way of saying the top front teeth stick out either because they’re positioned too far forward or the lower teeth are too far back. Protruding front teeth aren’t just an aesthetic concern, they’re also very susceptible to injury.
Treatments: Most of the time, we can move the teeth into position with braces or Invisalign treatment.

Overbite

When the upper front teeth extend too far beyond the lower front teeth, it’s known as an overbite. In some cases, the lower front teeth actually bite into the roof of the mouth. Overbites are associated with a “gummy” smile, protruding lips and excessive wear of the incisors.
Treatments: If the overbite is more severe and the patient begins treatment early, we can use appliances to help shift the jaws into their correct positions followed by braces. In other cases, we can remedy the problem with clear braces, metal braces, gold braces and sometimes lingual braces or Invisalign.

Crowding

If there isn’t enough room in the jaw for the teeth to erupt correctly, the teeth come in crooked and will either stick out or overlap. It’s the most common reason people seek out orthodontic treatment. It doesn’t just make the smile less attractive, it’s also been linked to periodontal problems and dental decay.
Treatments: We try to avoid extractions unless it’s absolutely necessary. Your options may include braces or Invisalign. If it’s severe, we can expand the jaw or recontour the teeth to make them narrower.

Spacing

Spacing is the opposite of crowding and it occurs when there’s too much room in the jaw because of genetics, teeth that are too narrow, tooth loss or habits like thumb sucking. When the teeth erupt, they can’t fill the entire space and gaps occur. This is another extremely common reason patients undergo orthodontic treatment.
Treatments: Braces or Invisalign will typically do the trick. Occasionally, you may need a little extra help from a dentist who will use veneers to make the teeth wider if the gap is too big to close with orthodontic treatment alone.

Openbite

This type of malocclusion can have a big impact on chewing ability because the upper and lower front teeth don’t overlap or meet when the jaws are closed. It can be the result of habits like tongue thrusting and thumb sucking or it could be thanks to genetics. It’s important to have an openbite evaluated early. If it’s a skeletal issue, early intervention could prevent the need for surgery.
Treatments: Treatment for an openbite will vary greatly depending on when it’s addressed, whether or not it’s skeletal and how severe it is. In some cases, orthognathic surgery combined with braces or Invisalign is the best option. When it’s diagnosed in children, early appliances followed by braces or Invisalign may help the patient avoid surgery.

Dental Midlines not Matched

When the midlines of the top and bottom teeth don’t line up it could be because one side of the jaw is longer than the other or because there’s more crowding on either the right or left side of the mouth. It can have a negative impact on jaw and dental function.
Treatments: Cosmetic dentistry combined with orthodontic treatment could be an option or sometimes orthodontics alone (braces or Invisalign) will suffice. If it’s a complex case, there may be a need for certain appliances as well.

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