Malocclusion is the dental term for misaligned teeth or an incorrect bite. It may seem like just a cosmetic issue, but the way your teeth fit together plays a vital role in chewing, speaking, and maintaining healthy gums and jaw joints. 

From crowded teeth to crossbites and underbites, different types of malocclusion can affect both children and adults. The good news is that modern dentistry offers a wide range of treatments to correct bite problems, restore function, and improve confidence.

Here’s a simple guide to understanding malocclusion, its types, and the treatments available.

What is Malocclusion?

Malocclusion refers to a misaligned bite, where the upper and lower teeth do not meet properly when the mouth is closed. This can occur due to crowded, crooked teeth, or because the jaws are not aligned as they should be.

In many cases, malocclusion is hereditary, meaning it often runs in families due to jaw size discrepancies and other genetic factors passed down through generations. However, it can also develop from other causes, such as tooth loss, habits like thumb sucking, or injuries to the teeth and jaw.

If left untreated, malocclusion can lead to a number of problems. These include tooth decay, gum disease, difficulties with chewing or speech, and, in some cases, jaw pain. It can also affect confidence and self-esteem, as people may feel self-conscious about the way their teeth look.

“The Bite” in Dentistry 

In dentistry, the way the teeth come together when the mouth closes is called the bite. Ideally, the upper and lower teeth should align properly so that the bite functions as it should.

When the bite does not fit correctly, i.e, a bad bite, it can lead to issues affecting both the teeth and the shape of the jaw, such as malocclusion.

An improper bite is not just a cosmetic concern. It may also cause headaches, ear or neck pain, difficulty with chewing, and a range of oral health problems.

Symptoms of Malocclusion

Malocclusion can present with a variety of signs, including:

• Frequent cheek biting.

• Difficulty biting or chewing food.

• Lisping or other speech difficulties.

• Misaligned or crooked teeth.

• Breathing through the mouth.

Causes of Malocclusion

Malocclusion may occur when teeth are too large or crowded for the mouth, or when the upper and lower jaws do not align correctly. Common causes include:

• Genetics and family history of misaligned teeth.

• Poorly fitted crowns, bridges, or other dental restorations.

• Impacted teeth.

• Prolonged thumb sucking or use of a pacifier during childhood.

• Teeth grinding (bruxism).

• Loss of teeth.

• Temporomandibular joint (TMJ) disorders.

• Tumours affecting the jaw or mouth.

Complications of Malocclusion

Oral Health Complications

• Tooth decay and cavities

• Gum disease

• Worn enamel

• Gum recession and injury

Functional Complications

• Difficulty chewing or biting

• Speech problems

• TMJ (jaw joint) pain and stiffness

• Jaw pain or discomfort

General Wellbeing Complications

• Headaches and neck pain

• Sleep apnoea or snoring

• Self-consciousness

6 Common Types of Malocclusion

1. Open Bite

An open bite makes proper chewing difficult. It is often caused by habits such as thumb sucking or tongue thrusting, which prevent the upper and lower front teeth from overlapping. This condition is defined by a lack of vertical overlap and can be:

• Anterior Open Bite – when the back teeth touch, but the front teeth do not overlap.

• Posterior Open Bite – when the front teeth align, but the back teeth do not meet.

2. Crossbite

In a healthy bite, the upper teeth should sit slightly in front of the lower teeth. A crossbite happens when the upper teeth fit inside the lower ones instead. This misalignment can interfere with chewing and biting, and if not treated, may worsen over time. Early treatment is highly recommended.

3. Underbite

An underbite occurs when the lower jaw extends beyond the upper jaw, causing the lower teeth to sit in front. This can put pressure on the jaw joints and, in some cases, prominent lower jaw appearance.

4. Crowding

Crowding happens when there isn’t enough room in the jaw for teeth to grow properly, often due to large teeth or limited space. It can lead to overlapping, crooked teeth and may increase the risk of:

• Tooth decay

• Cavities

• Gum disease

Orthodontic treatment, such as braces or, in some cases, tooth removal, is often required to create proper alignment.

5. Spacing

The opposite of crowding, spacing occurs when there are large gaps between the teeth, often caused by small teeth or a wide jaw. While mainly an aesthetic issue, untreated spacing can also contribute to gum problems in the future.

6. Deep Bite

A deep bite is when the upper front teeth overlap too much over the lower teeth. This can cause discomfort, as the lower teeth may press into the roof of the mouth or the gums. Over time, this may lead to gum disease, enamel wear, and difficulties with chewing.

Diagnosis And Tests Of Malocclusion

Malocclusion is usually identified during routine dental check-ups. Dentists may carry out a range of assessments, including:

• Dental impressions to produce study models of your teeth and bite.

• Dental X-rays to detect tooth decay or assess bone structure around the teeth.

• Photographs to examine the alignment of your teeth.

If malocclusion is detected, your dentist may refer you to an orthodontist,  a specialist in correcting bite alignment. While some general dentists can provide braces, more complex cases typically require specialist care.

Classification Systems for Malocclusion

Dentists and orthodontists use classification systems to categorise malocclusion based on jaw position and how the upper and lower teeth meet. One widely used system is the Ackerman and Profitt classification:

• Class I malocclusion: Upper teeth slightly overlap the lower teeth, with correct jaw alignment.
  
  

• Class II malocclusion: Upper teeth protrude significantly over the lower teeth, often with an underdeveloped jaw.
  
  

• Class III malocclusion: Lower teeth extend noticeably beyond the upper teeth, indicating an overdeveloped jaw; this type can be the most challenging to treat.
  
  

• Class IV malocclusion: Upper teeth sit far behind the lower teeth.
  
  

• Class V malocclusion: Upper teeth are positioned well forward of the lower teeth, often linked to an overdeveloped jaw.
  
  

• Class VI malocclusion: Lower teeth are positioned significantly behind the upper teeth.

Management and Treatment of Malocclusion

The treatment for malocclusion depends on the type and severity of the bite issue, as well as the patient’s age and overall oral health. A dental or orthodontic specialist will tailor the treatment to best correct the misalignment and restore optimal function and appearance. 

Common treatments include:

Orthodontic Solutions

• Braces: Traditional metal or ceramic braces gradually align teeth by applying gentle, consistent pressure over time. They are highly effective for various types of malocclusion.
  
  

• Clear aligners: Invisalign and similar clear aligners offer a discreet alternative to braces, moving teeth into place through a series of custom‑made trays that are removable for eating and cleaning.
  
  

• Orthodontic headgear: An appliance sometimes used to guide jaw growth in children and teenagers, helping to correct alignment before it becomes more complicated to treat.

Surgical Options

• Jaw surgery (orthognathic surgery): In severe cases, surgery may be necessary to correct structural problems with the jaw, particularly when the misalignment is caused by inherited jaw shape or injury.

Restorative Treatments

• Restorative dentistry: Procedures such as crowns, bridges, or veneers can repair or replace damaged teeth and support correct bite alignment.

  
  

• Tooth extractions: In cases of overcrowding, removing one or more teeth can make space for the remaining teeth to align correctly.

Prevention of Malocclusion

Many cases of malocclusion are hereditary, meaning they cannot always be prevented. However, environmental factors, such as missing teeth, can also contribute to bite misalignment. You can take steps to reduce the risk of developing malocclusion:

• Maintain good oral hygiene through regular brushing and flossing.

• Replace any missing teeth with dental implants or bridges to preserve proper alignment.

• Attend regular dental check‑ups and professional cleanings.

• For children, discourage prolonged thumb‑sucking or pacifier use beyond the age of four, as these habits can lead to bite problems over time.

Correcting Malocclusion for a Healthy, Confident Smile

Malocclusion is a common dental condition that can affect both oral health and overall wellbeing.

Understanding its types, causes, and treatment options is the first step towards achieving a healthier, more confident smile. Whether mild or complex, malocclusion can be effectively addressed with the right care and guidance.

At Bella Medical, our experienced orthodontic team provides personalised solutions to help you correct malocclusion and maintain lasting results. Early diagnosis and the right treatment can protect you from discomfort and complications in the future.