Common Orthodontic Problems
Malocclusion: what does that even mean?! A malocclusion is when the relationship of your teeth when you bite together is off. This is usually assessed from a lateral or profile view.
Class I occlusion is the ideal relationship with no crowding. What all orthodontists dream of (we just can't help it sometimes...)! Meanwhile, a Class I Malocclusion occurs when the teeth relate well, but there is crowding and misalignment.
A Class II Malocclusion occurs when the top teeth are forward relative to the lower teeth. These patients often exhibit a "Convex profile" or a small chin projection. Since the top teeth stick out, they are more at risk to trauma.
Less commonly we see a Class III Malocclusion. This is usually genetically driven, wherein the lower jaw (mandible) outgrows the upper jaw, which also tends to be undergrown. They exhibit a concave profile and very prominent chin. Sometimes a surgery is required to correct severe cases.
Sometimes in children, we see what we may call a Pseudo-Class III Malocclusion. This occurs when you habitually protrude the lower jaw forward when biting down. This is often is the result of a dental interference of the front teeth. Early treatment of the interference can easily resolve this positional problem.
A crossbite occurs when the upper teeth are narrower relative to the bottom teeth. In a Posterior Crossbite, since the lower jaw is wider, the top teeth sit on the inside and patients likely don't exhibit a broad smile.
This is commonly the result of decreased upper jaw growth in terms of width in the transverse dimension. This relationship is often corrected orthopedically with a Rapid Palatal Expander.
An Anterior Crossbite occurs when the bottom teeth jut out forward relative to the top teeth. This commonly is associated with a Class III Malocclusion, since the lower jaw is overgrown. It can be isolated to one tooth (like the picture) or be present for all of the front teeth.
An open bite can occur with either the front or the back teeth. With an Anterior Open Bite, there is no overlap of the top teeth in the front of the mouth. This is commonly a result of habits such as long-persisting thumb-sucking and/or a tongue thrust. Sometimes it is a result of genetics and excess growth in the vertical dimesnion.
A Posterior Open Bite happens when teeth in the back of the mouth don't meet vertically, which can inhibit chewing and put stress on the front teeth. This is often a result of a tongue habit or a genetically driven lack of dental eruption.
Spacing is pretty self-explanatory, but can occur for several reasons. In these cases, the teeth may be too small relative to the jaws. Sometimes a muscle attachment (called a frenum) can be physically preventing the teeth to come together. Even thumb sucking and tongue habits can cause irregular spacing patterns.
Crowding is one of the most common orthodontic problems that we treat. Many speculate that it has evolved as a result of changes in diet and industralization. However, the root of the problem is that there simply is not enough space in each jaw to fit the number of teeth in the mouth.
Crowding can lead to several issues besides general esthetic concerns. Dental crowding can cause dental impactions (pretty much teeth blocking and preventing adult teeth from erupting).
Crowding is often resolved by repositioning the teeth to have a broader archform or sometimes by pulling out teeth in severe cases.