January 22, 2007

Crooked Teeth and Misaligned Bites


There are several reasons why some people’s teeth grow in crooked, overlapping, or twisted. Some people's mouths are too small for their teeth, which crowds the teeth and causes them to shift. In other cases, a person's upper and lower jaws aren't the same size or are malformed, resulting in either an overbite (excessive protrusion of the upper jaw), or an underbite (the lower jaw protrudes forward, causing the lower jaw and teeth to extend out beyond the upper teeth).

What causes crooked teeth and misaligned bites?
Most often, crooked teeth, overbites, and underbites are inherited traits, just like the color of your eyes or size of your hands. Other causes of misaligned bites are early loss of baby or adult teeth; improper fit of dental restorations (for example, fillings or crowns); a jaw that is too small to accommodate erupting teeth; gum disease; undue pressure on the teeth and gums; misalignment of the jaw after severe facial injury; tumors of the mouth or jaw; or habits like prolonged thumb sucking, tongue thrusting, pacifier use beyond the age of three, or prolonged use of a bottle.

What problems are associated with crooked teeth and misaligned bites?
Crooked teeth and misaligned bites can:

Interfere with proper chewing.
Make keeping teeth clean more of a challenge, increasing the risk of tooth decay and cavities and gingivitis.
Strain the teeth, jaws, and muscles, increasing the risk of breaking a tooth.
Make people feel self-conscious about their appearance and affect their self-esteem.

How do I know if my teeth are crooked and my bite misaligned?
Your dentist can determine if your teeth are crooked and bite misaligned through a routine examination of your mouth, teeth, jaw, and facial appearance. Your dentist will look for the following signs:

Abnormal alignment of your teeth
Abnormal appearance of your face
Difficulty or discomfort when chewing or biting
Speech difficulties, including a lisp
Your dentist will usually refer you to an orthodontist, a dentist who specializes in the diagnosis and treatment of crooked teeth and misaligned jaws.

What tests will the orthodontist perform to determine if treatment is needed?
The orthodontist will likely take X-rays, photographs of your face, and impressions of your teeth to determine if and what type of treatment is needed. X-rays provide information on the position of your teeth and roots and whether any teeth have yet to come through the gums. Special cephalometrics or panoramic X-rays show the relationship of the teeth to the jaws and the jaws to the head. Your orthodontist may also want to take regular photographs of your face to further examine the relationship among your teeth, jaws, and head. Finally, impressions may be made of your teeth. This is done by having you bite down on a material that is later used to create an exact copy of your teeth.

What treatments are available to correct crooked teeth and misaligned bites?
Once a diagnosis is made, your orthodontist can decide the best treatment for you. For some people, a removable retainer (to stabilize the new position of teeth) will be all that's needed to correct the problem. Removal of one or more teeth may be required if overcrowding is the main problem. For most people, braces are necessary to correct the problem. In rare and extreme cases, such as an extreme overbite or underbite, an operation is necessary

Adapted from: Cleveland Clinic Foundation