Teeth malocclusion: classifications, causes and treatments

Teeth malocclusion is among the oral diseases that orthodontics can treat. Apart from bite and aesthetic problems, if not treated in time, malocclusion can lead to joint pain and even speech development problems in children. Therefore, early detection is important. In this article we’ll explain everything you need to know about the different types and classifications of malocclusions, as well as what exactly malocclusion of the teeth is and how to correct and treat it.

What is the meaning of malocclusion?

Before we get started it’s important to address what the malocclusion of the teeth means. When you take apart the word ‘malocclusion’ it really just means bad dental occlusion, or bite. Under normal conditions, the lower and upper arches fit together correctly, facilitating chewing and preserving the teeth. This isn’t true for teeth malocclusion. Therefore, we could define malocclusion as a disease in which the teeth of the upper jaw do not fit correctly with the teeth of the lower jaw.

Maloclussion classes and types

When we talk about dental malocclusion, we are not referring to a single specific problem: there are different types of bite problems. The classification of malocclusion is organised according to the plane they affect. Let’s take a look:

Sagittal malocclusion

Sagittal malocclusion is a type of bite problem that refers to the position of the lower and upper molars. Sagittal malocclusions are divided into three classes:

Class 1 malocclusion

Contrary to what its name suggests, class 1 malocclusion is when a patient has a normal bite, that is, there is a normal occlusion. However, there are dental alignment problems such as crowding or diastemas (gaps). Class 1 malocclusion is characterised by a predisposition to oral diseases such as caries, periodontitis and gingivitis. In addition, there is a greater erosion of the dental surfaces.

Class 2 malocclusion

In class 2 malocclusion, the maxillary first molar is further forward than the mandibular first molar. In addition, the upper incisors are often tilted in or out of the oral cavity, which is known as dental protrusion. The chin and lower lip of people with class 2 malocclusion are often retracted from the upper arch. Among the consequences of class 2 dental malocclusion, apart from excessive dental wear, there is also a greater tendency to suffer from bruxism.

Class 3 malocclusion

In class 3 malocclusion, the mandible is too far forward with respect to the upper jaw. This type of malocclusion, like the previous ones, can be caused by dental problems or bone problems. Apart from the aesthetic consequences, class 3 malocclusion usually leads to diseases in the temporomandibular joint and bite trauma. Within the class 3 malocclusion we find the edge-to-edge bite, which occurs when the front teeth come into contact when biting. In a normal occlusion, the top front teeth close in front of the bottom front teeth.

Transverse malocclusion

Transverse malocclusion is characterised by a discrepancy in the width of the upper and lower jaws and/or problems related to dental inclination. There are two types of transverse malocclusion:

Posterior crossbite malocclusion

 Posterior crossbite malocclusion is when the molars and premolars of the upper arch close and touch down inside the lower arch.

Scissor bite malocclusion

Scissor bite is the malocclusion in which the palatal surfaces (in inside part, closest to the tongue) of the upper molars and premolars collide with the buccal surfaces (the outside part, closest to the lip and cheek) of the lower ones.

Vertical malocclusion

In vertical malocclusions of the teeth there may or may not be contact between the upper and lower teeth, depending on the type of problem. Vertical malocclusion is further subdivided into different types of bite problems.

Open Bite malocclusion 

Open bite malocclusion is where the teeth do not overlap vertically. That is, patients who have this type of malocclusion, when closing their mouths, do not get their front teeth to come into contact.

Overbite malocclusion 

In overbite malocclusion, the teeth of the upper arch exceed more than a third of the teeth of the lower arch when closing the mouth, although there is contact between the premolars and molars, only the upper teeth cover the lower ones.

Malocclusion causes

Within the causes of malocclusion we find several factors, some avoidable and others are not:

• Hereditary factors. For example, an incorrect development of the jaws can be one of the causes of the malocclusion. Also, certain birth defects such as cleft lip or palate are inherited conditions that can also cause dental malocclusion.
• Bad oral habits. Habits such as sucking your thumb, mouth breathing or the use of a pacifier for many years are some of the factors that cause dental malocclusion.
  
• Absence of teeth. The absence of teeth, whether due to genetic causes, oral diseases such as pyorrhea or caries, or trauma, is another cause of malocclusion.
  

Malocclusion symptoms

If the occlusion problem doesn’t have obvious symptoms and isn’t very noticeable, it’ll be more difficult for the individual to identify the problem. However, when it comes to a problem with a certain degree of complexity, there are, in fact, certain symptoms that can help you detect this problem. Among the symptoms of malocclusion we find:

• Noises when opening and closing the mouth
• Facial, ear, jaw, or headache pain
  
• Malocclusion can also cause pain or difficulty during chewing
  
• Problems when closing or opening the mouth
  

Malocclusion consequences

Malocclusion of the teeth plays an important role when it comes to suffering from certain diseases or health problems. Among the consequences of malocclusion or a bad bite, the following could be highlighted:

• Aesthetic effects. Malocclusions alter the physiology of the face. They cause asymmetries, altering the normal harmony of the face.
• Health and oral hygiene problems. A dental malocclusion problem can lead to more serious health problems related to a deficit in oral hygiene. If we cannot adequately reach all the corners of our oral cavity, tartar or plaque can accumulate, which could lead to problems such as pyorrhea, swollen gums, and bad breath, among others. For this reason, it is vitally important to maintain good oral hygiene and prevent the diseases associated with malocclusion.
  
• Pain. Pain can be another consequence of malocclusion. This pain can be felt in the TMJ and lead to headaches.
  
• Other health problems. Malocclusion also causes respiratory problems as it can influence the correct closure of the mouth. It can also lead to speech-related problems.
  

Malocclusion treatment

Luckily, orthodontics has revealed how to correct and treat maloccluisons. In order to correct the bite we need to consult with an orthodontic specialist to analyse the case in detail and propose a personalised orthodontic treatment. The treatment of malocclusion always entails the need to carry out orthodontic treatment. As we have mentioned, it will be the specialist who dictates the steps to follow to correct the possible bite problems that exist depending on the severity and classification of the malocclusion.

Among the orthodontic treatments that can be applied to treat bite problems we find braces, clear aligners, palate expanders and extraoral appliances within interceptive orthodontics, to name a few. In addition to orthodontics, in some cases the correction of a bad bite may require orthognathic surgery (maxillary/mandibular surgery) or extraction of teeth in case there is a bone problem, but we want to avoid the surgical option. In any case, following the recommendations of the specialist is vital for the success of the treatment.

To relieve possible pain caused by dental malocclusion, rehabilitation therapy can also be carried out in case there is an overload in the TMJ or headaches and/or spine derived from the malocclusion.

Impress: specialists in correcting malocclusions and other dental problems

At Impress we are experts in clear orthodontics using removable aligners. We have an experienced medical team in both dental malpositions and bite problems. In addition, in our clinics we have cutting-edge technology that helps us diagnose and treat a wide variety of cases, including malocclusions of the teeth.

In the first visit we will carry out an exhaustive diagnosis of your bite and the state of mouth’s health. To do this, we perform X-rays, in addition to a 3D scan to obtain a detailed image of your oral cavity and a complete face-to-face dental check-up.

Thanks to our app, you will be able to follow your clear orthodontic treatment remotely, going only to the necessary clinic visits to adjust the treatment and make sure that everything is going perfectly. In addition, you will have 24/7 support through our app in case you have any problems or questions.

Our prices are closed with a fixed rate so you won’t have any surprises. You also have the option to finance your treatment if you wish. You can get in touch with us by WhatsApp, by phone at +44 20 3808 1072, or by filling out our online form to make an appointment to discover how we can solve your bite problem.

Come to your first visit and discover your personalised treatment plan with Impress. Find your nearest Impress clinic!