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Malocclusion of teeth
Alternative namesCrowded teeth; Misaligned teeth; Crossbite; Overbite; Underbite; Open bite
DefinitionMalocclusion means the teeth are not aligned properly.
Causes, incidence, and risk factors
Occlusion refers to the alignment of teeth and the way that the upper and lower teeth fit together (bite). Ideally, all upper teeth fit slightly over the lower teeth. The points of the molars fit the grooves of the opposing molar. All teeth are aligned, straight, and spaced proportionally. The upper teeth keep the cheeks and lips from being bitten and the lower teeth protect the tongue.
Signs and tests
Most malocclusion is discovered by the dentist during a routine examination. Occlusion is checked by pulling the cheek outward and having the person bite down normally, which tests the alignment of the back teeth. The dentist usually refers the person to an orthodontist for diagnosis and treatment.
Dental x-rays , head or skull x-rays , or facial x-rays may be required. Impressions (plaster or plastic molds of the teeth) are often needed.
The goal is to correct the positioning of the teeth. Braces or other appliances may be used. Metal bands are placed around some teeth or metal, ceramic, or plastic bonds are attached to the surface of the teeth. Wires or springs apply force to the teeth.
Extraction (removal) of one or more teeth may be required if overcrowding is part of the problem. Rough or irregular teeth may be adjusted down, reshaped, and bonded or capped. Misshapen restorations and dental appliances should be repaired. Surgery may be required on rare occasions. This may include surgical reshaping to lengthen or shorten the jaw (orthognathic surgery). Wires may be used to stabilize the jaw bone, in a similar manner to the surgical stabilization of jaw fracture.
Expectations (prognosis)Malocclusion is easier, quicker, and less expensive to treat when it is corrected early. Treatment is most successful in children and adolescents because their bone is still soft and teeth are moved more easily. Treatment may last 6 months to 2 or more years, depending on the severity of the case.
Treatment of orthodontic disorders in adults is often successful but may require prolonged use of braces or other devices.
Calling your health care providerCall your orthodontist if toothache, mouth pain, or other new symptoms develop during orthodontic treatment.
PreventionMany types of malocclusion are not preventable. Control of habits such as thumb sucking may be necessary in some cases. However, early detection and treatment may optimize the time and method of treatment needed.
Update Date: 10/9/2003Michael Kapner, D.D.S., Comprehensive and Aesthetic Dentistry, New Rochelle, N.Y., Editor, Ninth District Dental Association. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT