Malocclusion (Bad Bite)

Malocclusion means the teeth or jaws do not meet in the ideal position when you bite together. It covers crooked or crowded teeth, gaps, and problems with how the upper and lower jaws relate to each other. The ideal relationship is described as normal occlusion; malocclusion is any significant deviation from it.

Why It Matters

Mild malocclusion is very common and often causes no problems beyond appearance. More marked cases can make teeth harder to clean, cause uneven wear or chipping, put strain on the gums, and affect chewing or speech. Malocclusion is not the same as being "unhealthy", so treatment is based on function, oral health and the patient's own concerns rather than appearance alone.

Clinical Details

• Class I: The back teeth meet in the normal front-to-back position, but there are other problems such as crowding, spacing or rotated teeth. This is the most common type.
• Class II: The lower jaw and teeth sit further back relative to the upper. Often seen with a large overjet ("buck teeth") or a deep overbite.
• Class III: The lower jaw and teeth sit further forward, often producing an underbite where the lower front teeth bite in front of the upper ones.
• Other bite problems: Crossbite, open bite (front teeth do not meet), crowding and spacing such as a diastema.
• Causes: Mostly inherited jaw size and tooth size. Other factors include early loss of baby teeth, missing or extra teeth, prolonged thumb-sucking and injuries.
• Assessment: Clinical examination, photos, digital scans or models and X-rays to separate dental causes (tooth position) from skeletal causes (jaw position).
• Orthodontic treatment: Braces or clear aligners move the teeth; functional appliances can guide jaw growth in children.
• Surgical treatment: For significant skeletal problems in adults, jaw surgery is combined with orthodontics.
• Restorative options: Veneers or crowns can mask mild irregularities in tooth shape and alignment but do not change how the jaws meet. See veneers for crooked teeth for when this can and cannot work.

FAQ

What causes malocclusion?

Most cases are inherited, coming from a mismatch between the size of the jaws and the teeth or between the upper and lower jaw. Habits such as long-term thumb-sucking, early tooth loss and injuries can also contribute.

How is malocclusion fixed?

Dental malocclusion is usually corrected with braces or aligners, followed by a retainer. Skeletal malocclusion may need jaw growth modification in children or jaw surgery combined with orthodontics in adults.

Do I need treatment for malocclusion?

Not always. Mild cases may only be a cosmetic concern. Treatment is usually advised when the bite causes difficulty cleaning, tooth wear, gum damage, chewing problems or concern about appearance.

Can malocclusion cause jaw pain?

Some people with bite problems also have jaw pain, but the link is not straightforward, and many people with malocclusion have no jaw symptoms. Jaw pain should be assessed on its own.

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