Malocclusion: Causes, Types, Reasons and Treatment


A malocclusion is an incorrect relationship between the maxilla (upper arch) and the mandible (lower arch), or a general misalignment of the teeth.  Malocclusions are so common that most individuals experience one, to some degree, because the poor alignment of the teeth is thought to be a result of genetic factors combined with poor oral habits, or other factors in the early years.

Moderate malocclusion commonly requires treatment by an orthodontist who specializes in the treatment of malocclusions and other facial irregularities.

What Causes Malocclusion?

There are some conditions or habits that may change the shape and structure of the jaw,  include:

  • cleft lip and palate
  • frequent use of a pacifier after the age of 3
  • prolonged use of bottle feeding in early childhood
  • thumb sucking in early childhood
  • injuries that result in the misalignment of the jaw
  • tumors in the mouth or jaw
  • abnormally shaped or impacted teeth
  • poor dental care that results in improperly fitting dental fillings, crowns, or braces
  • airway obstruction (mouth breathing), potentially caused by allergies or by enlarged adenoids or tonsils

What Are the Different types of malocclusions?

There are different types of malocclusions, from crooked teeth to overbites – and they’re not all mutually exclusive.


Overcrowding is very common and it’s often caused by a lack of space, resulting in teeth that are crooked and overlap and it’s the most common reason for orthodontic treatment among adults.


An overjet is where your top teeth extend past your bottom teeth horizontally (not to be confused with an overbite). Protruding teeth can risk damage and cause problems with eating and speech.


While there should be some overlap of your lower front teeth, in some cases an increased overbite can cause your front teeth to bite down onto your gums.


A crossbite is where your upper teeth bite inside your lower teeth. In can happen on one or both sides of your jaw and it can affect your front or back teeth.

Anterior crossbite (underbite)

A crossbite that affects the front teeth is known as an anterior crossbite, or perhaps more commonly as an underbite.


Spacing can occur between two or more teeth. Some of the causes can include missing teeth, small teeth, tongue thrusting, and thumb sucking.


A diastema is a space between two teeth, usually the front teeth. Madonna and model Lara Stone famously both have diastemas.

Impacted tooth

An impacted tooth is one that’s unable to erupt through the gum normally. Possible treatments include removing the tooth, or exposing it so that a brace can be fitted.

Missing tooth

Missing teeth, or hypodontia, can occur as a result of teeth not developing properly or through trauma.

Open bite

An open bite is where the front teeth don’t overlap the lower teeth, so open bite affecting the front teeth is known as an anterior open bite

Reasons for Treating a Malocclusion

A severe malocclusion may lead to skeletal disharmony of the lower face.  In a more extreme case, the orthodontist may work in combination with a maxillofacial dentist to reconstruct the jaw. however, it is never too late to seek treatment for a malocclusion.  Children and adults alike have completed orthodontic realignment procedures and have been delighted with the resulting even, straight smile.

Here are some of the main reasons to seek orthodontic treatment for a malocclusion:

  • Reduced risk of tooth decay – A malocclusion often causes an uneven wear pattern on the teeth and the constant wearing of the same teeth can lead to tooth erosion and decay.
  • Better oral hygiene – A malocclusion can be caused by overcrowding.  When too many teeth are competing for too little space, it can be difficult to clean the teeth and gums effectively.  It is much easier to clean straight teeth that are properly aligned.
  • Reduced risk of TMJ – Temporomandibular jaw syndrome (TMJ) is thought to be caused by a malocclusion.  Headaches, facial pains and grinding teeth during sleep all result from the excessive pressure to the temporomandibular joint.  Realigning the teeth reduces pressure, and eliminates these symptoms.

Treating Malocclusion of the Teeth

Most people with mild malocclusion will not require any treatment. However, your dentist may refer you to an orthodontist if your malocclusion is severe. Depending on your type of malocclusion, your orthodontist may recommend various treatments. These can include:

  • braces to correct the position of the teeth
  • removal of teeth to correct overcrowding
  • reshaping, bonding, or capping of teeth
  • surgery to reshape or shorten the jaw
  • wires or plates to stabilize the jaw bone

Treatment for the disorder may also result in some complications. These include:

  • tooth decay
  • pain or discomfort
  • irritation of the mouth from the use of appliances, such as braces
  • difficulty chewing or speaking during treatment

How to Prevent Malocclusion?

Preventing the disorder can be difficult because most cases of malocclusion are hereditary. However, Parents of young children should limit pacifier and bottle use to help reduce changes in the development of the jaw. Early detection of malocclusion may help cut down on the length (and severity) of the treatment needed to correct the problem.


We love our patients and love to help them form healthy dental life that will last them a lifetime. For more information call us today to answer all of your questions so get an appointment