Malocclusion: Specialists and Information

Malocclusion is a type of dysgnathia. This term encompasses misalignments and developmental abnormalities of individual teeth, the jaws, and the masticatory system.

In some cases of malocclusion, no treatment is necessary, and the person affected can live with it without major problems. In other cases, however, it must be corrected to ensure the jaw functions properly.

In a healthy jaw, the teeth are arranged symmetrically. There should not be a large gap between the teeth, but they should not overlap each other either. Both jaws are exactly the same size so that, when the mouth is closed, the corresponding teeth align properly.

However, this ideal scenario is rare. Only about one in 20 people has such an ideal set of teeth. For everyone else, individual teeth may be misaligned, or the entire jaw may be misaligned.

The various types of malocclusion include:

• Crossbite: When the lower jaw is closed, the lower side teeth lie in front of the upper side teeth. This is by far the most common type of malocclusion. It can also affect only individual teeth.
• Open bite: Due to a developmental abnormality, gaps remain between the front teeth when the mouth is closed.
• Overbite: Jaws of different sizes: The upper jaw is too large or the lower jaw is too small. As a result, the upper teeth lie in front of the lower teeth.
• Underbite: The opposite of an overbite. The lower jaw is larger than the upper jaw. As a result, when the mouth is closed, the lower teeth lie in front of the upper teeth.
• Deep bite or overbite: The upper teeth are positioned too steeply. As a result, when the teeth are closed, they cover a large portion of the lower teeth.

Malocclusion can be caused by both hereditary factors and external influences. The lower jaw is more strongly influenced by hereditary factors, while the upper jaw is also affected by habits. For example, thumb-sucking or frequent and prolonged sucking on poorly shaped bottle nipples can contribute to malocclusion.

However, there are also some complex medical conditions that can lead to changes in the dentition and malocclusion. These include

• Down syndrome,
• congenital cleidocranial dysostosis (skeletal malformation),
• cleft lip and palate.

A malocclusion can cause problems with chewing. Ideally, a symmetrical arrangement is the best tooth alignment for breaking down food. A malocclusion can make chewing difficult.

However, the misalignment can also trigger muscle tension. This tension usually affects the temporomandibular joint, the shoulder area, or the neck. Additionally, it can lead to headaches and difficulty concentrating.

Furthermore, a misaligned jaw can impair breathing. Breathing normally occurs largely through the nose. However, if the mouth cannot be closed completely due to a misaligned jaw, this leads to increased mouth breathing. This increases susceptibility to infections.

Treatment for jaw misalignment is the responsibility of either a dentist or an orthodontist. Orthodontic treatment is only necessary if the misalignment affects

• chewing function,
• health, or
• significantly affects the person’s appearance

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Measures to correct a malocclusion can be taken as early as childhood. The most effective time for this is between the ages of nine and thirteen. During this period, jaw growth is not yet complete, and the permanent teeth have already come in.

In some severe cases, however, treatment may begin while the child still has baby teeth, for example in

• severe cases of crossbite or
• an open bite.

Malocclusion can be corrected, for example, with braces. Braces can correct the position of individual teeth, but not that of the entire jaw. A distinction is made between removable and fixed braces.

Fixed braces remain in the patient’s mouth for the entire duration of treatment and cannot be removed by the patient.

Removable braces, on the other hand, can be inserted and removed by the patient themselves. In most cases, the patient wears them only for a certain period of time each day. The patient’s cooperation is particularly important with this form of treatment. If the patient does not wear the removable braces regularly, no improvement can occur.

Surgery is usually considered only for adults with severe misalignments. It is an option when braces cannot sufficiently correct the severe misalignment.

The patient is placed under anesthesia during the surgery. The surgeon works exclusively within the oral cavity during the procedure to avoid facial scarring. For this reason, such surgery is often lengthy and complex. During the procedure, the surgeon removes various bone segments and replaces them if necessary.