Malocclusion of Teeth: Cosmetic or Functional?

Malocclusion, or misaligned teeth, are often a cause of cosmetic concern. However, apart from appearance, does malocclusion of teeth cause functional problems? Here we discuss the malocclusion of teeth, the risk factors, and treatment.

Malocclusion of teeth is a developmental disorder in which the teeth are not aligned properly. This condition causes upper and lower tooth misaligned; thus, they do not close properly. People with malocclusion of teeth will find it difficult to bite and close their mouths. It is one of the most common reasons for an orthodontic referral.

What causes malocclusion of teeth?

Although the cause of the malocclusion of teeth is not known, research has revealed some risk factors. A study states that the reasons for the malocclusion of teeth are divided into six groups:

• Trauma.
• Heredity.
• Certain diseases.
• Physical agents.
• Habits such as pacifier sucking.
• Unknown developmental problems.

A cross-sectional study on children and teenagers reported that cavities are a definitive cause of dental malocclusion. However, the study also concluded that premature loss of primary teeth and a tendency to crowd permanent teeth affected the condition. The scientists also noted that all patients with dental malocclusion required preventive orthodontic treatment. Malocclusion of teeth can also trigger temporomandibular joint (TMJ) problems and other periodontal health problems. Furthermore, individuals with dental malocclusion tend to be shyer or miss out on career opportunities due to the appearance of their teeth.

What are the symptoms of malocclusion?

In general, the symptoms of dental malocclusion include misalignment of the lower and upper teeth, changes in facial appearance, difficulty biting or chewing, and changes in speech (slurred). In addition, individuals with dental malocclusion also tend to mouth breathe and bite their tongue and inner cheeks more frequently. Furthermore, dental malocclusion in children can also trigger tooth decay, gum disease, and pain in the jaw, causing the premature loss of baby teeth.

Orthodontic classifications

Dental malocclusions are classified according to the position of the teeth and their relationship to the jawbone. Malocclusion is divided into three classes:

The Class I malocclusion presents with a normal relationship between the upper teeth, lower teeth, and jawbone. Therefore, it produces a balanced bite. However, Class I malocclusion occurs in the presence of crowding of teeth, rotation of the initial tooth position, spacing (the space between the teeth), the presence of wide teeth (protrusive teeth), and retrusive teeth.

In contrast, Class II dental malocclusion presents with an abnormal relationship between the teeth and jaws. Because the jaw and upper teeth protrude more forward, commonly known as an overbite, it causes a more receding lip and chin profile. The causes of Class II dental malocclusion include the overdevelopment of the maxilla (upper jaw) and the underdevelopment of the mandible (lower jaw). Genetic factors and finger-sucking habits are the primary triggers for Class II dental malocclusion.

Class III malocclusion occurs when the teeth and mandible protrude more forward than the maxilla. The profile and contour of the face are more concave with a protruding chin — a hallmark characteristic of Class III malocclusion. This is commonly known as an underbite. As with Class II, Class III malocclusion can also be caused by genetic factors. Furthermore, excessive mandibular growth with minimal maxillary growth predisposes to Class III malocclusion. Complications that can occur in Class III malocclusion include the anterior functional shift of the mandible to a severe maxillomandibular discrepancy.

Can malocclusion be cured?

Dental malocclusion treatment is generally done to correct the jaw and teeth position. Braces can pull the teeth and jaw slowly. Braces will move the teeth consistently to shift into their proper position permanently. Furthermore, functional dental devices can still be used to treat Class II malocclusions. Installation of this dental appliance aims to correct the relationship between the functional jaw and the skeletal to form a flat facial soft tissue profile. This device offers a protrusive effect on the mandible and a restrictive impact on the maxilla.

For individuals who don’t want to wear braces, transparent dental aligners can also be used to align teeth. In addition, clear braces (e.g., Invisalign or similar brands) can treat various dental malocclusions. This dental appliance offers a transparent appearance with optimal tooth and jaw alignment. Individuals with dental malocclusion who wear Invisalign for 20 hours daily experience significant dental and jaw correction. The company’s 3D-scanning technique shapes the device to fit each patient's facial profile.

Furthermore, in cases of Class III malocclusion, interceptive treatment is essential to prevent damage to the oral tissues. It also aims to reduce the severity and number of orthodontic interventions. Orthodontists can also use functional and fixed dental appliances to repair Class III malocclusion. Treatment with a chin cup device can direct mandibular growth vertically. It can make the mandible rotate backward. This rotational change helps correct Class III malocclusion. With severe malocclusion, orthognathic surgery (corrective jaw surgery) can be performed. It includes moving and rotating the jaw forward, backward, or widening it to obtain a symmetrical jaw position.

Malocclusion of teeth can lead to cosmetic as well as functional problems such as changes in facial appearance and difficulty in eating. This condition can be treated with braces, clear braces, or surgery. A dentist can answer any questions or concerns related to the malocclusion of teeth.