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Malocclusions: Causes, Types, Diagnosis and Treatment Methods

27 January 2022

Categories: Braces, Invisalign
Wearing Invisalign aligner on teeth model

Occlusion is defined as the way the upper and lower jaw meets. Normal occlusion, which is a neatly aligned set of teeth, makes it possible for healthy oral functions such as chewing food properly and healthy speech development. 

However, in some instances, normal occlusion doesn’t occur and this is known as malocclusion. Malocclusion refers to teeth misalignment (i.e. having crooked teeth). If left untreated, it can lead to oral health complications.

Read on to learn more about the causes of malocclusions in children and adults, types, diagnosis, treatment and FAQs!

Malocclusion Causes in Children

The cause of malocclusions in children are largely hereditary. However, there are certain circumstances or habits that may alter the shape of a child’s jaw in their early years. 

For example,

  • Cleft lip and palate
  • Thumb sucking when young
  • Frequent use of pacifier above 3 years of age
  • Bottle feeding for extended periods of time
  • Oddly shaped teeth
  • Impacted teeth
  • Injuries causing jaw misalignment
  • Mouth or jaw tumours
  • Small spaces between baby teeth

 

Malocclusion Causes in Adults

  • Wear and Tear

    We use our teeth every day to eat and speak. And while we sleep, we may also grind or clench our teeth. So, it’s quite natural for some wear and tear to happen, causing teeth to shift.

  • Teeth Crowding

    With age, our jaw bone gets smaller as the density decreases. This causes an imbalance between the teeth and size of the jawbone, potentially leading to crowding of teeth.

  • Poor Dental Hygiene

    A good practice is to get your teeth professionally cleaned and checked by a dentist every 6 – 12 months.

    Otherwise, poor dental hygiene could lead to decay or cavities and cause you to lose your teeth. If not replaced, this may lead to misalignment of the teeth.

  • Gum Disease

    Gum disease is another consequence of poor dental hygiene, as it indicates a buildup of plaque.

    It can result in loosening of teeth, receding gums and declination of the jawbone. These usually cause tooth loss, which may contribute to teeth misalignment.

There are 7 main types of malocclusions. Each of these teeth misalignments present different issues such as challenges in chewing, speaking and/or increased risk of plaque buildup.

An overbite is when the upper teeth overlap with the lower teeth vertically. Most individuals have some form of overbite. If it’s minor, treatment may not be required.

Why is it a concern?

If the overlap is severe, it can cause headaches and increase the tendency of grinding and clenching which causes jaw pain. Thus, in such cases, orthodontic treatment is advised.

An overjet is when the upper front teeth overlap with the lower front teeth horizontally. Also known as buck teeth, this accounts for 26.3%* of malocclusion cases in Singapore.

Why is it a concern?

You may experience difficulty in chewing, drinking, biting and speaking. You may also bite your tongue or the inside of your cheek frequently. Overjet may even cause jaw pain and difficulty to close your lips.

An open bite is when the upper and lower teeth don’t come into contact when the mouth is closed. In Singapore, this is not a common condition as only 4%* experience this.

Why is it a concern?

Open bite can make it difficult to chew and bite food. This dental condition can also interfere with speech and cause dental problems such as fractured teeth.

An underbite is when the lower teeth protrude and appear in front of the upper teeth. This type of malocclusion is usually inherited and surgery may be advised for severe cases.

Why is it a concern?

Individuals with an underbite will have difficulties with chewing food, speaking and the teeth of your lower jaw might wear down faster too.

A crossbite is when some of the upper teeth sit behind the lower teeth. Factors such as genetics and a prolonged thumb sucking habit contribute to crossbite.

Why is it a concern?

Crossbite can cause tooth decay, sleep apnea, frequent headaches, pain in your jaw as well as shoulder and neck muscles.

Crowded teeth is when there’s insufficient space for all teeth to fit nicely. Thus, causing your teeth to overlap, twist, getting it pushed towards the front or back.

Why is it a concern?

Crowded teeth can make it difficult to brush and floss well, causing plaque and bacteria to buildup in the mouth.

Diastema refers to a gap between any two teeth, most commonly the upper front teeth. While this may have been normalised by supermodels, it poses some dental concerns.

Why is it a concern?

Diastema affects both children and adults and may cause plaque buildup in the gaps, potentially leading to periodontal disease.

An overbite is when the upper teeth overlap with the lower teeth vertically. Most individuals have some form of overbite. If it’s minor, treatment may not be required.

Why is it a concern?

If the overlap is severe, it can cause headaches and increase the tendency of grinding and clenching which causes jaw pain. Thus, in such cases, orthodontic treatment is advised.

An overjet is when the upper front teeth overlap with the lower front teeth horizontally. Also known as buck teeth, this accounts for 26.3%* of malocclusion cases in Singapore.

Why is it a concern?

You may experience difficulty in chewing, drinking, biting and speaking. You may also bite your tongue or the inside of your cheek frequently. Overjet may even cause jaw pain and difficulty to close your lips.

An open bite is when the upper and lower teeth don’t come into contact when the mouth is closed. In Singapore, this is not a common condition as only 4%* experience this.

Why is it a concern?

Open bite can make it difficult to chew and bite food. This dental condition can also interfere with speech and cause dental problems such as fractured teeth.

An underbite is when the lower teeth protrude and appear in front of the upper teeth. This type of malocclusion is usually inherited and surgery may be advised for severe cases.

Why is it a concern?

Individuals with an underbite will have difficulties with chewing food, speaking and the teeth of your lower jaw might wear down faster too.

A crossbite is when some of the upper teeth sit behind the lower teeth. Factors such as genetics and a prolonged thumb sucking habit contribute to crossbite.

Why is it a concern?

Crossbite can cause tooth decay, sleep apnea, frequent headaches, pain in your jaw as well as shoulder and neck muscles.

Crowded teeth is when there’s insufficient space for all teeth to fit nicely. Thus, causing your teeth to overlap, twist, getting it pushed towards the front or back.

Why is it a concern?

Crowded teeth can make it difficult to brush and floss well, causing plaque and bacteria to buildup in the mouth.

Diastema refers to a gap between any two teeth, most commonly the upper front teeth. While this may have been normalised by supermodels, it poses some dental concerns.

Why is it a concern?

Diastema affects both children and adults and may cause plaque buildup in the gaps, potentially leading to periodontal disease.

Diagnosis of Malocclusions in Children

Parents are encouraged to bring their children for their first dental checkup when they’re 1 year old, and twice a year subsequently. This will allow any teeth misalignment issues to be pointed out early.

By age 6 or 7 when their permanent teeth start erupting, it’s good to schedule an appointment with a dentist or orthodontist! They’ll check for malocclusions and advise on whether orthodontic treatment is necessary.

 

Diagnosis of Malocclusions in Adults

Malocclusion in adults is diagnosed during routine dental checkups. The dentist will examine your teeth and conduct X-rays (if required) to check for misalignment.

Braces

As part of cosmetic dentistry, braces is an orthodontic treatment that uses metal brackets, wires and modules to reposition your teeth.

Frequency of dental visits: Every 4 weeks
Cost: $4,173 – $6,206 (with GST)

Invisalign

Invisalign is a clear aligner system that uses a patented SmartTrack® material and SmartStage™ technology to optimise teeth movements.

Frequency of dental visits: Every 6 – 8 weeks
Cost: $4,815 – $9,095 (with GST)

Surgery

For malocclusions that are caused by skeletal problems, orthodontic treatment won’t be sufficient. Dentists will provide a referral to an oral surgeon in such cases.

During the surgery, the upper/lower jaw may be moved forward or backward, or widened to align your jaw symmetrically.

FAQs

  • Class 1 Malocclusion

Class 1 malocclusion refers to minimal skeletal issues where the upper teeth overlap with the lower teeth slightly. This is the most common class seen in Singapore, present in 48.1%* of the population.

  • Class 2 Malocclusion

Class 2 malocclusion refers to the overlapping of the upper front teeth over the lower front teeth. The class 2 division 1 malocclusion is the most commonly seen in Singapore at 26.3%*. This is when the upper jaw and teeth are tilted forward, which is also known as an overjet.

  • Class 3 Malocclusion

Class 3 malocclusion refers to teeth misalignment caused by protrusion of the lower jaw. This may lead to underbite or open bite cases, and account for 22.4%* of cases locally.

Malocclusions are largely hereditary, so it may be a challenge to prevent them. However, teeth alignment may be affected by environmental factors as well.

Some tips to keep in mind are to:

  • Refrain from prolonged use of pacifier and bottle feeding
  • Stop your child from sucking their thumbs excessively

This minimises changes in jaw development.

The key is to remember that early detection of malocclusion may help reduce the severity and length of treatment required!

If left untreated, malocclusions will cause a number of health problems including:

  • Decayed teeth
  • Gum disease
  • Difficulty chewing or speaking
  • Teeth grinding
  • Losing teeth due to excessive wear
  • Jaw joint pain
  • Speech difficulties
  • Self-esteem
  • Airway obstruction by enlarged adenoids/allergies especially in children

Thus, you’re advised to get your teeth straightened for better dental health and improved confidence!

*Statistics retrieved from KK Women’s and Children’s Hospital. Data is accurate as of 2018 and shown only to be used as a gauge.

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