What is malocclusion?

Malocclusion refers to any degree of irregular contact of the teeth of the upper jaw with the teeth of the lower jaw. This would include overbites, underbites, open bites, and crossbites. There is no specific system of deciding how much misalignment is too much. Your child's orthodontist will decide whether your child's bite will need correction. Malocclusion can cause problems with the child's bite, gum tissue, jaw joint, speech development, and appearance.

Orthodontists are specially trained dentists who specialize in the development, prevention, and correction of irregularities of the teeth, bite, and jaws. Orthodontists also have specialized training in facial abnormalities and disorders of the jaw. A patient often consults an orthodontist after receiving a referral from his or her general dentist. In some cases, a specialist in jaw surgery may need to be consulted.

What causes malocclusion?

There is no one single cause of malocclusion. Many different factors are involved, including genetic factors and/or environmental factors. Children who suck their thumbs or fingers beyond the age of 5 have an increased chance of developing malocclusion. Children with a very small space between their primary teeth (baby teeth) are at risk for having problems with malocclusion when their permanent teeth appear, because the permanent teeth are larger and require more space.

According to the National Institutes of Health, very few people have perfect occlusion. However, most occlusion abnormalities are so minor that they do not require treatment.

How is malocclusion diagnosed?

Malocclusion is usually diagnosed based on a complete history and physical examination of your child and your child's mouth. Your child's doctor will probably refer the child to a dentist or an orthodontist for complete evaluation and treatment. The following tests may also be done to help evaluate the problem:

• X-rays. A diagnostic test that uses invisible electromagnetic radiation to produce images of internal tissues, bones, teeth, and organs onto film of the mouth or head, or to capture the images in digital form on a computer.

• Impressions of the teeth. Imprints of the teeth that are poured with plaster to make models of the mouth to help evaluate the malocclusion.

Treatment for malocclusion

Specific treatment for malocclusion will be determined by your child's dentist or orthodontist based on:

• Your child's age, overall health, and medical history

• Extent of the condition

• Your child's tolerance for specific medications, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

Treatment is sometimes done in phases depending of the extent of the malocclusion. In some cases, removal of the baby teeth is needed to help provide room for the permanent teeth. Select permanent teeth are also sometimes removed. Other treatment may include:

• Jaw surgery (orthognathic surgery). In some cases, the child may need jaw surgery to correct the bite problem when the bones are involved. This is performed by a maxillofacial surgeon.

• Mouth appliances:

  • Removable appliances. Mouth appliances (for example, retainers) made of wires and plastic can be inserted and removed by the child and must be cleaned on a regular basis.

  • Fixed appliances (also known as braces)

• Good oral hygiene, including regular brushing and flossing.

The following foods should be avoided while wearing any type of mouth appliance:

• Gum

• Sticky foods

• Peanuts or other nuts

• Popcorn

• Ice

There may be some activity restrictions based on the type of appliance that is used. Discuss this with your child's dentist or orthodontist.