Jaw and Dental Misalignments | Modern Orthodontics for Jaw Misalignments

Various types of dental misalignment are grouped under the umbrella term “dental malocclusion.” This refers to a situation where one or more teeth are outside the ideal dental arch or where there is a structural jaw misalignment. In medical terminology, this is referred to as dysgnathia.

In cases of dental or jaw misalignment, the teeth are either crooked or have not grown into the correct position. This can affect both the upper and lower rows of teeth or the relationship between the upper and lower jaws. The key factors are how the teeth relate to one another and whether the bite closes properly.

Severe misalignments are considered an aesthetic defect. They can also have serious health consequences. In medical terminology, dental misalignment is referred to as dentoalveolar dysgnathia.

Malocclusion is usually easily recognizable at first glance.

This young man has malocclusion © Konstantin Aksenov | AdobeStock

The following types of malocclusion are particularly common:

• Overbite
• Crossbite
• Deep bite
• Underbite
• Crowding
• Open bite
• Supernumerary teeth

An overbite is a particularly common form of malocclusion; it is also colloquially referred to as “bunny teeth.” In an overbite, the upper jaw is overdeveloped or the growth of the lower jaw is disrupted. In some cases, the lower jaw is too long or too short in relation to the upper jaw. This results in a visible gap between the upper and lower incisors, even when the mouth is closed.

A crossbite occurs when the molars do not align correctly. This results in abnormal stress on the jaw.

In an open bite, on the other hand, either the incisors or the molars do not align correctly. This results in a clearly visible gap between the teeth.

In a deep bite (also known as an overbite), the upper incisors cover the lower row of teeth too much when the teeth are closed. 

Crowded teeth, caused by a lack of space, are also very common. This is a concern because it makes cleaning the teeth significantly more difficult. If the spaces between the teeth are too narrow, it is difficult to reach between them with a toothbrush, and plaque cannot be effectively removed. Crooked teeth may become visible.

A diastema refers to a gap between the front teeth, often caused by an overly strong labial frenulum.

Three-dimensional illustration of crooked teeth due to lack of space © Alexandr Mitiuc | AdobeStock

Not every case of malocclusion causes symptoms. Many misalignments are merely a cosmetic concern. In cases of more severe malocclusion, various problems can arise, such as difficulty chewing and speaking, a lisp caused by misaligned incisors, and pain in the jaw and neck area. A malocclusion places excessive strain on individual teeth.

Crowded teeth make oral hygiene more difficult, which increases the risk of cavities and periodontitis. This is especially true when the lower teeth or the upper teeth are severely misaligned. For these patients, it is all the more important to undergo regular professional teeth cleaning.

If, for example, the incisors are slightly tilted, affected patients may experience significant difficulty biting into food. In this case, it makes sense to have the misalignment corrected.

If the teeth do not align properly, this can lead to further health issues. Many patients report tension in the jaw and neck muscles. This, in turn, can trigger tinnitus or migraines.

Severe malocclusions should therefore be corrected to prevent secondary conditions. Otherwise, malocclusions are purely a cosmetic issue, and treatment is not strictly necessary.

Treatment for misaligned teeth is tailored to each individual and depends on the severity and extent of the misalignment, the patient’s age, and any possible jaw misalignments. The goal of treatment is the functional and aesthetic correction of misaligned teeth, harmonizing both the position of the teeth and the relationship between the upper and lower jaws.

The dentist is the first point of contact for misaligned teeth. The dentist often refers the patient to an orthodontist. After a comprehensive diagnosis, a suitable treatment method is selected. Depending on the findings, removable braces, fixed braces, or clear aligners may be used. This orthodontic treatment results in the gradual movement of the teeth, normalizing the bite and reducing abnormal stress on the jaw. 

Especially during childhood and adolescence, ongoing jaw growth can be utilized therapeutically. In cases of severe skeletal malocclusion, additional oral and maxillofacial surgery may be necessary—for example, to correct an overjet or to create space in the jaw for subsequent orthodontic treatment. Throughout the entire orthodontic phase, careful oral hygiene is essential to prevent tooth decay and periodontitis. After active treatment is completed, a retention phase stabilizes the new position of the permanent teeth to prevent the misalignment from recurring.

Modern dental practices perform a 3D scan of the teeth and can immediately identify malocclusions. The orthodontist determines which treatment method is appropriate for you on a case-by-case basis. An individualized treatment plan is created for each patient.

In most cases, misalignments are corrected using braces. A distinction is made between removable and fixed braces.

Removable braces have the advantage that they can be taken out for oral hygiene.

The most popular and effective form of treatment currently is aligner trays. They have the significant advantage of being suitable for most types of misalignment and being quite discreet.

Aligner trays for treating misaligned teeth in adults © REDPIXEL | AdobeStock

Whether health insurance covers the cost of treatment depends on how the misalignment is classified. Orthodontists are required to categorize dental misalignments into so-called indication groups. Health insurance covers part of the costs starting with Group 3. However, this system applies only to children.

Adults and those covered by statutory health insurance generally have to pay for the treatment themselves.

As a general rule, the earlier treatment for malocclusion begins, the better the prognosis. If braces are fitted during childhood, there is a high likelihood that the malocclusion can be completely corrected.

However, misalignments can certainly be corrected in adults as well. The first choice is usually aligners, which must be worn for an average of six months.

Of course, the duration of wear varies from patient to patient and depends on the severity of the misalignment.

What are the most common types of misaligned teeth?

The most common types include overbite, crossbite, underbite, crowded teeth, and diastema.

Are misaligned teeth genetic?

Many malocclusions are genetic or hereditary, but they can also result from external factors.

When should orthodontic treatment begin?

Ideally, treatment should begin during childhood or adolescence, when changes in the jaw and teeth become apparent.

Does health insurance cover the costs?

For children, health insurance may cover part of the cost, depending on the severity of the misalignment. Adults usually bear the costs themselves.

Can crooked teeth be corrected in adulthood?

Yes, with modern orthodontic treatment—using aligners or braces—crooked teeth can be effectively treated even in adulthood.