Types of Malocclusions and Orthodontic Treatments Available

Class I Malocclusions

Class I dental malocclusions affect more than half of orthodontic patients. They also are the easiest to correct, as they involve misalignment of the teeth only, with normal bone, tissue, and jaw structures. A Class I malocclusion can present as overlapping or crowded teeth, rotated teeth, gaps between teeth, or improper angling.

Crowding

Crowding typically occurs when there is not enough space in the mouth to allow teeth to align. Overcrowding can be mild, moderate, or severe depending on how many teeth are affected and how far out of place they are. Though genetics is the main predictor of crowding, it also can be caused by the premature or delayed loss of primary teeth.

Overcrowded teeth can create difficulties in brushing and flossing properly, leading to the buildup of plaque and bacteria. This increases susceptibility to cavities and gum disease. This risk is heightened if the crowding is moderate to severe. Straight teeth are easier to brush and floss, which facilitates better dental health. Poor oral hygiene can lead to health problems over time, including a weakened immune system and heart disease.

Patients suffering from crowding alone have many options for orthodontic correction. In most cases, the orthodontist can use ceramic braces, traditional metal brackets, or alternatives such as clear aligners or lingual braces. Dental veneers also can mask mild to moderate crowding for adult patients.

Spacing

Teeth spacing is a condition in which gaps appear between some or all of the teeth. This typically occurs when teeth are too small or too much space exists in the mouth. An overgrowth of the tissue that borders the gum line and the upper front teeth also can cause spacing, and the tissue can sometimes bulge between the teeth.

If the gums above the two upper front teeth overextend and cause a gap, you might need surgery to remove excess tissue. If your orthodontist diagnoses you with gum disease, she will have to treat that before she corrects the spacing.

Braces are commonly used to fix spacing, and your orthodontist can help you determine whether traditional braces, clear braces, removable braces, or lingual braces are right for you. Other methods of filling in gaps include veneers and bonding.

Class II Malocclusions

Class II malocclusions refer to protrusions of the upper teeth. This class is somewhat less common than Class I, comprising about one-third of orthodontic patients. Protrusions require more intervention to correct because the orthodontist must fix the misalignment of the bite in addition to the teeth.

Overbite

An overbite occurs when the top front teeth excessively overlap the bottom when the mouth is closed. This stresses the teeth, causing them to grind and wear down prematurely. It also increases the risk of tooth decay. An overbite might cause a patient to frequently bite into the roof of the mouth, causing painful sores and ulcers.

If untreated, a child’s overbite will allow the teeth to crowd each other and grow crooked if there is too little room or create too much space between teeth if the jaw area is too large. This can eventually cause significant jaw pain, facial pain, and headaches. Orthodontists can correct a mild or moderate overbite in children and teens with braces and growth modification devices such as blocks, repositioning appliances, or headgear.

Braces can only correct mild overbites in adults. Because the jaw has finished growing, appliances can no longer help shape or adjust it. Therefore, significant overbites typically involve invasive procedures such as tooth extraction or jaw surgery.

Overjet

An overjet occurs when the upper front teeth protrude. In a normal bite, the upper front teeth should rest relatively snugly over the bottom front teeth when the mouth is closed. In an overjet, the teeth grow at a more horizontal angle.

Braces are the most popular method for correcting overjets, including traditional metal braces and removable clear aligners.

Another option is extracting premolars to create space and guide the front teeth into better alignment. Patients with inadequate jaw development may require surgery.

Class III Malocclusions

Class III malocclusions affect about 10 percent of patients and occur when the lower jaw protrudes, causing the lower teeth to overlap the upper ones. This is the most difficult malocclusion class to treat, as it involves significant manipulation of jaw bones.

Underbite

An underbite occurs when the lower teeth extend beyond the upper teeth. This condition can cause cosmetic concerns and functional problems.

Patients with underbites often suffer from jaw pain. Underbites can cause chronic mouth breathing, halitosis, bacterial infections, enamel wear, and even sleep apnea.

Early treatment is ideal, as younger patients respond well to appliances such as upper jaw expanders and reverse-pull headgear.

Adults typically require surgery to lengthen the upper jaw or shorten the lower jaw. Mild cosmetic underbites may be improved using veneers.

Crossbite

A crossbite occurs when the top and bottom teeth do not align properly when biting. An anterior crossbite affects some front teeth; a posterior crossbite affects the back teeth.

Crossbites make teeth harder to clean and accelerate gum recession. Braces, clear aligners, and in some cases expanders or surgery, are used to correct them.

Open Bite

An open bite occurs when the upper and lower front teeth do not meet when the mouth is closed. This can strain the back teeth and cause decay, wear, and eating difficulties.

Braces usually correct open bites in adolescents; adults may require jaw surgery.

If you are concerned about a misalignment or bite issue, schedule a free consultation with one of our board-certified orthodontists today.