MALOCCLUSION

Is a problem in the way the upper and lower teeth fit together in biting or chewing.
The word malocclusion literally means bad bite or poor bite. This condition may
also be referred to as an irregular bite, cross bite or overbite. Malocclusion should be
corrected because it predisposes to dental caries, may lead to digestive disorder and
inadequate nutrition because of difficulty in chewing and can cause serious
psychological effects if there is facial distortion. Corrective treatment is provided by
an orthodontist, who may apply appropriate dental appliances to improve the
position of the teeth.

Types of malocclusions
Upper protrusion (over jet) - in an upper protrusion, the upper front teeth are
pushed outward (buck teeth). A small lower jaw may be the cause. Pacifier
use of thumb-sucking can also create this condition by pushing teeth outward,
sometimes causing the roof of the mouth to change shape (upper palate).
Spacing or crowding problems - too much or too little room for the teeth
can cause spacing or crowding problems. Crowding can prevent permanent
teeth from coming in properly or at all (impaction).
Misplaced midline - In people who misplaced midline, the front center line
between the upper front teeth doesnt match up with the center of the lower
front teeth.
Open bite - although the molars fits together in a person who has an open
bite, the upper and lower teeth dont overlap. This creates an opening straight
into the mouth. An open bite can also be present on one or both sides of the
mouth.
Over bite (deep bite) - in a person who has an excessive overbite, the upper
front teeth reach too far down over the lower front teeth and, in severe cases,
can cause the lower teeth to bite into the roof of the mouth.
Under bite - an under bite is present when the lower front teeth are father
forward than the upper front teeth
Cross bite - a cross bite occurs when any or all of the upper teeth fit into the
wrong side of the lower teeth.
Rotation - rotation is present when a tooth turns or tips out of its normal
position.

 Transportation transposition occurs when teeth grow (erupt) in one

anothers place.

Categories of malocclusion
Class I (neutrocclusion) - the most common malocclusion. The bite is
normal, but the upper teeth slightly overlap the lower teeth
Class II (Distocclusion) - is also called retrognathism or overbite, occurs
when the upper jaw and teeth severely overlap the bottom jaw and teeth.
Class III (Mesiocclusion) - is also called prognathism or underbite, occurs
when the lower protrudes or juts forward. Causing the lower jaw and teeth to
overlap the upper jaw and teeth.

Causes
Malocclusion are most often inherited, but may be acquired:
Inherited conditions:

To many or too few teeth

Too much or too little space between teeth
Irregular mouth and jaw size and shape
Atypical formations of the jaws and face (eg. Cleft palate)

Acquired conditions:

Oral habits (eg. Finger or thumb sucking habits, mouth breathing)

Tongue thrusting
Premature loss of teeth ( accidental or dental disease)
Use of pacifier
Medical conditions (eg. Enlarged tonsils and adenoids) lead to mouth
breathing.

Symptoms
The most obvious sign of malocclusion is crooked or protruding teeth. Physical
symptoms of malocclusion are uncommon but can range to severe.

Abnormal alignment of the teeth

Difficulty or discomfort when biting or chewing

Slurring speech, trouble saying certain words or other speech problems.

Abnormal appearance of the face
Mouth breathing breathing the mouth without closing the lips.

Treatment:
The goal of treatment is to correct the positioning of the teeth. Correcting
moderate or severe malocclusion can:

Braces or other appliances: metal bands are places around some teeth, or
metal, ceramic or plastic bonds are attached to the surface of the teeth. Wires
or spring apply force to the teeth. Clears braces (aligners) without wires may
be used in some patients. (retainer are needed to stabilize the teeth after

having braces)
Removal of one or more teeth: this may be needed if overcrowding is part

of the problem.
Repair of rough or irregular teeth: teeth may be adjusted down, reshaped,
and bonded or capped. Misshapen restorations and dental appliances should
be repair.

During the orthodontic treatment for malocclusion, its still important to take good
care of teeth at home. The orthodontist will give instructions on caring for the teeth
during treatment these are:

Avoid sticky and hard foods, such as gum, taffy and nuts.
Taking vitamins with fluoride
Carefully brush your teeth after meals and snacks.
Have a regular dental visit/ check-up

Prevention:
There are steps to prevent of the tooth loss, which can lead to malocclusion.

Mouth guard- use when playing any kind of sports

Basic dental care prevent tooth decay
Avoid putting a baby or toddler to bed with a bottle. Sugars in the liquid can
cause tooth decay.

Diagnostic test

Most problems with teeth alignment are discovered by a dentist during a routine
exam. The dentist may pull your cheek outward and ask you to bite down to check
how well your back teeth come together. If there is any problem, the dentist may
refer to orthodontist for diagnosis and treatment. Common test are:

Dental X-ray
Head or skull X-ray
Facial X- ray

Medical management

Analgesics- treatment for pain from newly installed or adjusted braces for

malocclusions. (eg. Ibuprofen or acetaminophen for 3-5 days)

Do not give aspirin to anyone younger than 20 without a prescription because
of the risk of Reye syndrome, a serious illness that can cause severe liver and
brain damage.

Surgical management
Surgery to create better alignment between an adults upper and lower jaw is
sometimes combined with orthodontic treatment for malocclusion.

Orthognathic surgery treats malocclusion by restructuring the jaw through

cutting the bone and repositioning the bone segments.