Overview of Malocclusion

Malocclusion is also known as a poor bite. Malocclusion is basically a misalignment of the teeth. The term bite means how the upper and lower jaws are arranged. Besides this, the further terms which can be used are crowded bite, crossbite, underbite, open bite, and overbite.

Malocclusion is mostly a genetic disease but sometimes, it is a cosmetic problem. Moreover, crooked teeth are difficult to care for properly, thus tooth decay or loss may start earlier. It may lead to difficulty in speaking and eating if the problem is severe.

Signs and Symptoms of Malocclusion

Depending upon the types of malocclusion there are various symptoms. Some are under here:

  • The appearance of the face alters
  • Frequent chick and tongue biting
  • Discomfort when chewing or biting
  • Speech alters along with improper development of lips
  • Overbite or underbite teeth

Types of Malocclusion

On the basis of the arrangement of teeth, malocclusion is classified into three basic types. These include:

  • Class 1 Malocclusion

Class 1 malocclusion is the most common type and is less severe as well. There is a slight overlap of upper molars with lower molars in a good position, but other teeth are either spaced or crowded. 

  • Class 2 Malocclusion

It is also known as retrognathism (or retrognathia). Class 2 malocclusion is characterized as overbite in which the upper jaw and teeth severely overlap the lower jaw and teeth. The lower jaw has a much smaller size than usual.

  • Class 3 Malocclusion

The third type of malocclusion is diagnosed as the larger size of the lower jaw than the upper jaw thus also known as prognathism, which means protruding lower jaw and teeth. Commonly it is named an underbite, as the lower jaw overlaps with the upper jaw.

Causes of Malocclusion

There are many causes of malocclusion including differences between the size of lower and upper jaws and the shape of teeth. Certain habits or situations can also be responsible for this problem. These are:

  • More or little gaps in jaws for teeth
  • Cleft lip and palate
  • Frequent use of pacifier exclusively after three years of age
  • Prolonged use of bottle feeding during childhood
  • Thumb sucking
  • Severe injuries which have disturbed the alignment of the jaw
  • Tumor in jaw or mouth and tooth loss
  • Ill-fitted dental fillings, crown, dental application, or braces
  • Airway obstruction

Risk Factors of Malocclusion





The orthodontist will examine the condition of the patient’s teeth and prescribe how they are likely to develop without treatment.

The assessment will involve:

  • Go through full medical and dental health history
  • Carrying out a clinical examination
  • Taking X-Rays of the teeth and jaw
  • Making plaster models of the teeth

Next, the orthodontist will decide on a treatment plan.

Treatment of Malocclusion | When to Consult a Doctor

Devices Applied to Treat Malocclusion

Broadly there are two types of devices: fixed and removable.

Fixed Devices

These are commonly used appliances in orthodontics to improve the alignment when teeth are severely overbite or underbite. Patients with fixed devices can eat normally but few edibles like carbonated drinks, hard candy, gum, and sticky foods are prohibited.

  • Braces: Braces are brackets, wires, or bands. Bands are applied strongly around the teeth and serve as an anchor for appliances, while brackets are fixed at the front teeth.

  • Fixed-space maintainer: When a child will lose his baby tooth, a space maintainer stops two teeth on either side of space from moving into the space. 

  • Removable-space maintainer: This is an alternative to a fixed-space maintainer.

  • Special fixed devices: These exclusively inhibit thumb sucking and tongue thrusting. They may be uncomfortable, especially during eating thus these are applied if necessary.

Removable Devices

These are applied when there are slightly crooked or crowded teeth. These devices are only put off during cleaning, eating, or flossing. Usually, an orthodontist recommends the patient remove them while doing certain activities such as playing a wind instrument or cycling.

  • Aligners: These are alternatives to braces and are useful for adults. These are unnoticeable by others and can be removed while brushing, eating, and flossing. An aligner is used for 2 to 3 weeks and then is replaced with a tighter one.

  • Headgear: A strap around the back of the head is attached to a metal wire in the front, or face bow. The aim is to inhibit upper jaw overgrowth and keep the back teeth in place while the front ones are forced back.

  • Lip and cheek bumpers: These are exclusively used to lessen the pressure of cheeks or lips on teeth.

  • Palatal expander: Palatal expander is designed to form an arch of the upper jaw broader. It is made up of plastic plates and screws that are put on the palate. The screws exert pressure on the joint in the jaw bones, pushing them outward. This enhances the area of the palate.

  • Tooth retainer:  Teeth naturally tend to grow out of the position, even after treatment. Thus the patient needs to wear a device called a ‘retainer’ in his mouth to lessen the drift out the tendency of teeth. Some patients have to use a retainer for a long duration after treatment. 

Growth Modification


Some children need an early treatment that is known as growth modification. In this, the child wears a device that assists the jaw to move in a better position and this treatment works best during the child's growth spurts.