Malocclusion is the misalignment of one’s teeth or when the relationship between the upper and lower dental arches is incorrect. Malocclusion requires the use of orthodontics to correct the problem. The first “modern” orthodontist was Edward Angle, who defined malocclusion as not having normal occlusion of the teeth. Malocclusion, simply put, is a deviation from the normal occlusion and affects things like chewing, talking or aesthetics of the mouth.
Classification of malocclusion types:
There are three major classifications of malocclusion. The Edward Angle classification takes into account the relationship between the molars. There are three types or classes in the Angle classification. They include:
- Class I: the dental arches are normal and the first molars are normally aligned. Other teeth, however, are spaced to close together or too far apart or they are misaligned.
- Class II: There is an abnormal relationship between the dental arches with the mandibular teeth being distal to maxillary teeth. In division 1 of this class, the upper incisors protrude and in Division 2, the upper incisors are pushed inward, toward the tongue.
- In class III, there is an abnormal relationship between the dental arches and all the mandibular teeth occur mesial to the normal. The mandibular arch is longer than the maxillary arch.
In the canine classification, there are three classes. Class I means the maxillary permanent canine occludes between the first premolar and the mandibular canine. Class II means that the maxillary permanent canine occludes in front of the space between the mandibular canine and the first premolar. Class III means that the maxillary permanent canine occludes behind the space between the mandibular and the first premolar. Other teeth can be misaligned as well.
In the incisor classification, the classes are similar to the Angle Classification. In Class I, the lower incisors occlude the cingulum plateau of the upper incisors. In Class II, the lower incisor tips occlude or lie behind the cingulum plateau of the upper incisors. In class III, the lower incisor tips lie in front of the cingulum plateau of the upper incisors.
Causes of malocclusion:
The causes of malocclusion include inherited causes. One might be born with too many teeth in a portion of their mouth or too few teeth, leading to space and angle problems with the teeth. You can have the wrong jaw size or the wrong facial features to fit the maxillary teeth. You can acquire malocclusion from thumb sucking, the thrusting of one’s tongue or early loss of teeth due to accidental reasons or diseases of the teeth. Other medical conditions, including mouth breathing from enlarged tonsils and adenoids, can cause malocclusion.
Common complications:
Why have ideal occlusions? There are those that believe it’s just an aesthetic thing; however, most orthodontists know that malocclusion can lead to periodontal disease, dental caries, headaches and tooth pain. Some people have no symptoms at all while others are highly symptomatic.
There are many complications of malocclusion including those mentioned above. The biggest complications include discomfort of the mouth, which can occur without treatment or during treatment, tooth decay from malocclusion, mouth irritation from maloccluded teeth or from treatment with dental appliances, chewing and speaking problems.
Prevention of malocclusion:
Prevention of malocclusion includes not sucking one’s thumb or fingers, avoiding tongue thrusting maneuvers, correcting issues related to mouth breathing, such as removal of adenoids and tonsils and avoiding prolonged loss of any teeth, which might have been lost due to trauma to the teeth. Replacing lost teeth quickly will be expensive but may avoid a more extensive and expensive orthodontic procedure.
Treatment Options in Malocclusion:
The primary treatment option in malocclusion is the use of dental appliances. Dental appliances gradually pull back the teeth into normal alignment. It involves the progressive application of devices that realign the teeth.
Orthodontic treatment isn’t a risk-free option. For example, appliances can decalcify the teeth and can result in enamel opacities, especially on the labial surfaces of the teeth. This happens in half of all patients. The treatment can cause periodontal disease from the appliances. Enamel fracture can occur as can resorption of the tooth roots. There can be tooth pulp pain and gingivitis from the appliances. Many of these risks are usually worth the effort and people have appliances placed for malocclusion all the time.