Malocclusion of teeth is how dentists and orthodontists refer to a misaligned bite. It is commonly known as a “bad bite.”
Malocclusion is a potentially serious oral health problem that can lead to dental issues like overbite, underbite, crossbite, and tooth overcrowding.
Fortunately, ways exist to treat malocclusion, one of the most common being dental braces.
In this article, we discuss what causes malocclusion of teeth, what the symptoms and consequences of untreated malocclusion are, and how braces and other orthodontic treatments can correct crooked teeth in children.
If you have any questions about your children’s teeth, please call Ironwood Pediatric Dentistry at (480) 422-4544.
What Causes Malocclusion of Teeth in Children?
There are many possible ways that your child can develop crooked teeth. Some you have no control over; others you can exert some influence on. What follows are the common causes of malocclusion.
Genetic Causes of Malocclusion
Hereditary reasons are a common source of malocclusion of teeth. If a child’s parents have experienced crooked teeth, then the chances increase considerably that the child, too, will experience them.
Specific genetic causes of malocclusion include:
- Genetic influence on the size and position of the jaws
- Birth defects, like a cleft lip and palate
- One or more impacted teeth, which are teeth fully or partly trapped inside the gum tissue
Problems With Jaw and Tooth Development
Problems can occur with the development of your child’s permanent teeth that are unconnected with genetic causes, but can still lead to malocclusion problems. These include:
- Tooth loss: If a child loses one or more teeth, the resulting gap can cause the adjacent teeth to shift position unnaturally, leading to crooked teeth and bite problems.
- Rotated teeth: Sometimes teeth can grow in ways that are not straight, which can prevent them from coming together properly when biting, and which can contribute to the surrounding teeth shifting position.
- Extra teeth: In some cases, your child may have too many teeth for the size of his or her jaws, which leads to overcrowding. This can cause teeth to grow out of their proper position or have trouble erupting.
Poor Childhood Oral Habits
Sometimes children can persist in behaviors that, if they are allowed to continue, can affect the position of the upper front teeth. These include:
- Digit sucking, particularly thumb sucking. This puts unnatural pressure on the upper front teeth, leading to overbite and open bite malocclusion.
- Prolonged use of a pacifier or bottle-feeding. The effects of using a pacifier or bottle for too long are similar to those of digit sucking.
- Lack of proper oral care, like brushing and flossing, can lead to issues like tooth decay and gum disease. These in turn can lead to tooth loss or to weak gums, either of which can result in shifting teeth.
Mouth Structural Causes
Occasionally, oral health problems that are not connected to genetic reasons can contribute to malocclusion. These include:
- Airway obstructions
- Injuries to the mouth
- Mouth tumors
- Improperly placed dental crowns or fillings
Malocclusion Symptoms
Crooked teeth are a symptom of the causes above, but they also lead to symptoms themselves. These include:
- Difficulty with biting and chewing
- Pain in the jaw, ears, or face
- Cheek and tongue biting
- Speech difficulties, like having a lisp
- Mouth breathing, and difficulty opening and closing the mouth
- Changes to the structure of the face
Malocclusion can also impact your child’s mental health.
Often, children with bad bite issues may experience problems with self-confidence and self-esteem, and avoid social engagement and relationships because they feel self-conscious about their appearance.
Malocclusion Classes and Types
Pediatric dentists diagnose misaligned teeth or a misaligned jaw through dental examination. The diagnostic process can include dental X-rays, models, and other diagnostic tools to evaluate your child’s mouth, head, and neck.
Once your child’s dentist identifies malocclusion, before treatment the next step is to further classify it by class and type.
Malocclusion Classes
There are six classes of malocclusion, based on the position of the upper and lower first molars. The table below describes each of these classes.
| Malocclusion Class | Description |
| Class 1 malocclusion | The jaw aligns properly, but your child’s upper teeth stick out slightly beyond the lower teeth. |
| Class 2 malocclusion | The jaw is underdeveloped. Your child’s upper teeth stick out significantly beyond the lower teeth. |
| Class 3 malocclusion | The jaw is overdeveloped. Your child’s lower teeth stick out significantly beyond the upper teeth. A class III malocclusion is often the most difficult kind to fix. |
Types of Malocclusion
Malocclusion classes are significant to pediatric dentists. What may be more important to you as a parent is the type of malocclusion your child is diagnosed with. There are several types of bad bites; here are the most common ones.
- Crossbite: The upper teeth fit inside the lower teeth when closing the mouth.
- Open bite: The upper and lower front teeth don’t touch when closing the mouth.
- Overbite: This is a deep vertical bite that happens when the upper teeth overlap the lower teeth more than they should.
- Overjet: The upper front teeth stick out further than they should. This condition is also known as “buck teeth.”
- Underbite: The lower front teeth extend beyond the upper front teeth.
- Overcrowding: There is not enough space to fit all the teeth within the mouth. This can lead to teeth rotation, crooked teeth, or overlapping teeth.
- Impacted Teeth: An impacted tooth is stuck within the gums and unable to erupt fully into the mouth. This commonly happens with wisdom teeth and canine teeth.
- Missing Teeth: Also known as hypodontia. This condition can happen naturally, or can arise from trauma or another dental issue.
- Teeth Gap: This is also known as diastema, and is most often seen between the upper two front teeth.
- Teeth Spacing: Some of the most common causes of teeth spacing are missing teeth, small teeth, and dental habits like tongue thrusting and thumb sucking.
Malocclusion Treatment and Prevention
Your pediatric dentist has several ways to treat malocclusion of teeth. Which is most appropriate for your child will depend on the class and type of the bad bite condition, along with variables like how much room is available in your child’s mouth and the overall health of his or her teeth, gums, and jaw bone.
Your child’s dentist may also refer you to an orthodontist for orthodontic treatment planning.
How Long Does Treatment for Malocclusion Take?
On average, it takes about two years to complete malocclusion treatment. In milder cases treatment may only require a few months, while in more severe cases treatment may take three years or longer.
Braces for Malocclusion
Dental braces, including traditional metal braces, ceramic braces, and lingual braces, are the most common childhood teeth malocclusion treatment. Braces can be used by themselves, or in combination with other orthodontic treatment appliances like headgear and jaw expanders.
The main advantages of braces are that they are effective in treating most kinds of malocclusion problems and—especially for metal braces—are less expensive than some other treatment options.
The potential downsides of braces are that metal braces are highly visible, and it can be more challenging to keep them clean by brushing and flossing.
Invisalign for Malocclusion
Removable clear plastic aligners, like Invisalign, may also be an option.
Instead of the brackets, wires, and elastic bands that braces use to exert gradual pressure to move teeth into their proper positions, clear aligners accomplish this through a series of trays your child wears on the upper and lower teeth for about two weeks at a time. Each new set of trays is custom-made to build on the progress the prior set has made.
Clear aligners have several advantages compared to braces:
- They are easily removable, making it practical for your child to eat more kinds of foods because there is no need to avoid hard or sticky foods that could damage the brackets or wires of braces.
- They make it easier to brush and floss teeth.
- Compared to braces, they are much less visible.
The potential downsides of clear plastic aligners are:
- They require self-discipline to use effectively. Clear aligners must be worn about 22 hours a day to work properly. Leaving them out too often and for too long can slow down the tooth realignment process, and this can mean that new sets of trays will need to be made.
- They must be cleaned thoroughly and properly to avoid staining and plaque buildup on their surfaces.
- They can cost a little more than braces treatment.
Dental Bonding for Malocclusions
Dental bonding is an alternative to braces in mild malocclusion cases.
This procedure uses a tooth-colored material applied to abnormally shaped or crooked teeth to change their shape, size, and color. Dental bonding does not reposition teeth; it is more of a cosmetic remedy.
The main advantage of dental bonding is that it is a simple and inexpensive way to overcome the visible aspects of mild malocclusion to restore an appealing smile.
The downsides are that it does not address the underlying causes of teeth malocclusion.
Tooth Extraction for Malocclusions
Your child’s pediatric dentist or orthodontist may recommend tooth extraction in cases of severe dental malocclusion, such as cases caused by teeth overcrowding.
It is often used in combination with braces.
Oral Surgery for Malocclusions
In particularly severe cases of malocclusion, such as a bad bite condition caused by mispositioned jaws, oral surgery (also known as orthognathic surgery) may be necessary to reposition the jaws and teeth.
Your orthodontist will consult with an oral surgeon to perform jaw surgery if it is needed.
Dental Retainers for Malocclusions
Dental retainers are usually used after braces are removed.
Their main purpose is to keep teeth from shifting back to their previous positions while the jaws and gums adapt to the new alignment.
In mild cases of malocclusion, retainers may be used in lieu of braces, similar to Invisalign.
Can Malocclusion be Prevented?
There is nothing you can do to prevent malocclusion classes caused by genetic factors like irregular teeth or tooth overcrowding; however, in other situations, there are some behavioral measures you can take with your child to reduce the risk of malocclusion from getting started because of environmental factors.
Here are some practical tips to help prevent malocclusion from becoming a problem:
- Discourage digit sucking.
- Avoid prolonged use of pacifiers and bottle feeding.
- Encourage good oral hygiene habits, such as brushing and flossing, to maintain healthy and strong teeth, gums, and jawbones.
- If your child engages in contact sports, make sure he or she uses a mouthguard.
- Schedule your child for regular checkups with a pediatric dentist to diagnose malocclusion problems and, if necessary, remove teeth or replace lost teeth with a bridge or dental implant.
Do You Have Questions About Child Teeth Malocclusion?
If you believe that your child has a bad bite condition, our pediatric dentists and orthodontists at Ironwood Pediatric Dentistry can help. With a thorough dental examination, we can tell you if a problem exists and what you can do about it.
Our doors are open for all pediatric dental needs, including malocclusions. We can help you with early prevention, education, and promotion of good oral hygiene habits, and we provide quality dental treatments, including braces, Invisalign, and more.
Call our office in Scottsdale, Arizona, at (480) 422-4544 to speak with an experienced child dentist today. You can also use our online contact form to ask a question or set up an appointment.
