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Malocclusion of Teeth - Diagnosis and Treatment

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Last Reviewed 20 June 2024

Medically reviewed by Dr. Paul O'Connell, Bachelor Dent. Sc. (Trinity College Dublin) 2004, Practice Limited to Orthodontics

Table of Contents

Malocclusion is a common condition that causes tooth misalignment and bite issues. The good news is that it's highly treatable through orthodontics treatment and other dental procedures.

Seeking support from a orthodontist can help you reduce symptoms and look forward to a brighter smile. 

What Is Malocclusion Of Teeth?

Malocclusion refers to misaligned teeth or improper positioning when the jaws are closed. It's a common condition impacting over 50% of people worldwide.

Dr. Paul O'Connell

While some people seek orthodontic treatment for the aesthetic issues malocclusion often causes, others look for treatment to prevent complications with eating, swallowing, and chewing.

Types Of Malocclusion

OvercrowdingWhen the jaw isn't large enough to accommodate the upper and lower teeth, they can overlap or become crooked.
GapsSome people's jaws are larger, and the teeth that grow can cause gaps and spaces. While some might experience minor gaps, others can have large spaces that are more noticeable.
DiastemaThis condition causes a gap between two teeth - usually the upper front teeth.
OverbiteOverbites are common malocclusions when the upper teeth protrude over the lower teeth.
UnderbiteOpposite to overbites, an underbite means the lower bottom teeth extend over the top teeth when the jaw is closed.
Open biteOpen bite malocclusion causes the top and bottom teeth to form a gap when the mouth is closed.
CrossbiteCrossbites occur when the upper teeth bite inside the lower teeth. Some people might have it on one side of their jaw, while others might experience more pronounced crossbites.
HypodontiaCommonly known as missing teeth, hypodontia usually happens when the teeth don't develop properly.
Impacted teethIf a tooth doesn't grow through your gum correctly, it can become impacted. Wisdom teeth are the most common form of impactions but can occur anywhere.

What Causes Malocclusion?

Braces for Malocclusion of Teeth

Braces for Malocclusion of Teeth

Unfortunately, in most cases, malocclusion is unavoidable, as it occurs due to genetic factors. The size of your jaw, the shape of your teeth, and their size define whether you'll experience the condition. If a family member has malocclusion, you're more likely to develop it.

Aside from genetic factors, there are other potential causes of the condition - most of which are avoidable:

Childhood Habits

Most babies and toddlers display thumb-sucking habits and use pacifiers, but prolonged usage can lead to malocclusion later in life. The pressure both activities create can impact jaw and dental development, leading to malocclusion of the upper and lower teeth.

Dental Development

An individual's dental development can also increase their risk of malocclusions. The premature loss of baby teeth can cause issues with permanent teeth, including misalignment and spacing. Abnormal tooth development, including extra or missing teeth, can cause malocclusion.

Jaw And Face Injuries

When the jaw or face undergoes trauma, it can impact the alignment of your teeth. Jaw fractures and dislocations are common contributors to misalignment issues, as they affect the natural bite. Lost teeth can also be problematic, as the gap can influence adjoining teeth.

Poor Oral Health

Taking care of your oral health is integral to ensuring a straight smile. Unfortunately, gum disease and tooth decay can lead to the premature loss of teeth. When this happens, it impacts the surrounding teeth, resulting in alignment issues.

Jaw Growth And Size

Your bite depends on how the upper and lower jaws grow, with slight discrepancies contributing to malocclusion.

Some people might have larger or smaller jaws on average, while others might experience asymmetry when one half of the jaw grows more than the other.

Medical Conditions And Dental Procedures

Dental procedures, including bridges and crowns, can also cause alignment issues. However, finding an experienced dentist to perform these procedures will reduce the risks.

In rare cases, cysts or tumours might grow in the jaw, impacting the placement of your teeth and bite.

What Are The Symptoms Of Malocclusion?

While some people with malocclusion don't experience symptoms, those with more pronounced misaligned teeth and bite issues can suffer from numerous effects, including:

  • Problems biting and chewing food due to misaligned teeth not fitting together properly.
  • Severe malocclusion can also cause extensive jaw pain due to the additional pressure. Some people also experience clicking and popping of the jaw.
  • Overcrowding or crooked teeth are more challenging to clean, which might cause decay and gum disease over time.
  • When the teeth severely overlap, it might result in speech issues caused by improper lip and tongue positions.
  • Malocclusion issues that impact the jaw's temporomandibular joints often cause significant headaches and migraines, making it hard to perform daily activities.
  • Bite issues can cause pressure on the teeth, resulting in pain and wear. If the problem continues without treatment, it can cause abnormally shaped teeth.
  • Malocclusion is an aesthetic problem, too, and some people might experience low self-esteem due to an uneven smile.
  • In the most severe cases, misaligned teeth and bite issues might impact your airways, making breathing hard.
dr. bobby price

Dr. Bobby Price

Diagnosis And Classes Of Malocclusion

A qualified dentist can identify malocclusion by examining the teeth and jaw to ensure they align correctly. If they notice potential problems, they'll take an X-ray to better understand the malocclusion issues.

The X-ray also lets your dentist classify your condition based on severity and how it impacts you. There are three classes of malocclusion:

Class 1Class 1 is the most prevalent form of malocclusion, in which the bite is considered normal, but there might be some minor crowding, tooth rotations, and spacing. Some people don't notice symptoms other than aesthetic issues, and class 1 malocclusions are relatively easy to treat.
Class 2Pronounced overbites and overjets which cause significant overlaps, fall into the class 2 malocclusion category. Some people develop the condition because their lower jaw is too small or set back , also known as retrognathism.
Class 3While less common than overbites, underbites typically cause more complications, giving them the most severe classification. Known as prognathism, they occur due to a pronounced lower jaw, which leads to the lower teeth overlapping the upper teeth.

Malocclusion Of Teeth Treatment

Numerous types of malocclusion treatment are available depending on your symptoms and classification. When your dentist first diagnoses you, they'll review the extent of your alignment issues and develop a bespoke treatment plan to correct malocclusion.

Before Braces Treatment
After Braces Treatment

Before and After (Click to enlarge)

- Adult Braces


Braces are the gold standard of orthodontic treatments, as they can straighten the jaw and teeth, gradually moving them into their correct positions. Your orthodontist will evaluate the severity of your malocclusion and recommend a brace based on their findings.

Fixed Orthodontic Appliances

Also known as train track braces, these braces are fixed with metal brackets and wires to correct many orthodontic issues. They apply pressure to each tooth, gradually correcting alignment and rotation problems.

Ceramic Braces

6-month Braces Before
6-month Braces After

Before and After (Click to enlarge)

- 6 Month Braces

Adults worried about the aesthetic implications of fixed orthodontic appliances can use ceramic brackets, which perform the same functions but aren't as noticeable.

6-month Braces

Six-month braces can benefit individuals with minor crowding and spacing issues. They straighten teeth quickly and repair minor misalignments.

While they won't work for more pronounced malocclusions, they're ideal for adults who want quick results.


Once you finish your initial treatment, you'll wear a retainer to ensure the teeth remain in their new positions.


aligners for orthodontics - 3dental

A Spark Aligner At 3Dental

Aligners are known for treating a range of orthodontic issues without causing cosmetic issues. They're invisible and removable, allowing people to benefit from ongoing treatment without anyone noticing.

The duration you'll wear the aligners depends on the severity of your malocclusion and how often you wear them. While aligners are excellent treatment options, they're unsuitable for severe misalignment or crowding issues.

Invisalign Before
Invisalign After

Before and After (Click to enlarge)

- Invisalign


Invisalign aligners are ideal for people with crooked teeth, spacing, and minor bite issues (for example, when the upper teeth slightly overlap the lower teeth). The treatment time is usually 1 to 1.5 years, but Invisalign Go can offer faster results for those with mild orthodontic issues.

Spark Aligners

Dr. Bobby Price Discusses The Spark Aligner Treatment

Dr. Bobby Price Discusses The Spark Aligner Treatment

Spark Aligners are a more cost-effective option than Invisalign, but they still offer the same treatment outcomes. Utilising TruGEN™ allows Spark to create aligners that remain invisible and discreet. People with minor bite issues, including open bites, can benefit from Spark Aligners.

Dental Procedures

Severe misalignments might require dental procedures that restore and reshape the teeth while addressing cosmetic effects. Treatment options include:

  • Veneers: If you want to improve the appearance of one or more teeth, veneers can reshape them and give you a new smile.
  • Dental bonding: As a more affordable alternative to porcelain veneerscomposite and edge bonding go directly onto the tooth's surface, reshaping it to enhance your appearance.

Gum Contouring

Gum reshaping isn't a direct malocclusion treatment, but it can be beneficial if excess gum tissue contributes to your teeth appearing misaligned. It's often used with other treatments, such as braces and surgical procedures, to enhance treatment outcomes.

Tooth Extraction

Wisdom Teeth Extraction Procedure by Dr. Anna Beattie

If you suffer from overcrowding, your dentist might recommend a tooth extraction. These procedures are beneficial if your teeth have insufficient space. Removing one or more teeth can give your remaining teeth adequate room to realign.

Jaw Surgery

Individuals with severe bite issues might require more intensive treatment, such as corrective jaw surgery. An oral surgeon will assess how significantly your upper or lower jaw protrudes and then move it into the correct position.

Most patients require orthodontic treatment after jaw surgery, but the procedure can remove bite issues. Because these surgeries require extensive orthodontic planning and coordination, they're usually only advisable if orthodontic appliances alone won't work.

How To Prevent Malocclusion Of Teeth?

Before smile in a day Treatment
After smile in a day Treatment

Before and After (Click to enlarge)

Malocclusion is often genetic, so there aren't any ways to prevent it. However, regular dental visits can help your dentist identify and treat issues before they worsen.

As covered before, not all causes are genetic, and the following steps can prevent you - or your child - from developing alignment issues:

  • Break bad habits: Discouraging young children from thumb sucking and extensive pacifier use can prevent misaligned teeth in the future. Adults should also refrain from tongue-thrusting.
  • Seek immediate treatment for missing teeth: Lost teeth can often result in malocclusion as the surrounding teeth will adapt to the space. Seeking treatment immediately stops this from happening.
  • Oral health is key: Good oral habits such as brushing twice daily, flossing regularly, and going for regular dental checkups will maintain your smile.

How 3Dental Can Help?

Malocclusion can cause numerous symptoms and complications, but seeking treatment is the best way to tackle the condition head-on and look forward to a better smile. 3Dental is Ireland's premier provider of a range of teeth malocclusion treatments.

We specialise in smile transformations, combining our decades of experience in orthodontics, cosmetic dentistry, and dental surgery. With a dedicated team of professionals, our Dublin, Galway, and Limerick practices treat all forms of misalignments, bite issues, crowding, and spacing.

We give you more confidence and self-esteem. Please book a free consultation today or contact us for more information.

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