Dental Problems

Malocclusion of Teeth – Classification and Symptoms

Malocclusion of teeth is a condition where there is misalignment between the teeth of two dental arches. The word Malocclusion refers to the manner in which one dental arch meets the opposing arch. A typical malocclusion appears as shown in the figure. In this article, we shall know the classifications, causes and symptoms of malocclusion of teeth.

The term Malocclusion is coined by Edward Angle, the father of modern orthodontics. Malocclusions are also thought as the result of other conditions such as skeletal disharmony of the face. In skeletal disharmony of face, there is problem with meeting of upper and lower jaws.

Classification of malocclusion of teeth

There are 3 categories or classifications of malocclusion. The figure below shows the classification graphically.

  • Class 1This is the most common type of malocclusion. Here the upper teeth slightly overlap the lower teeth.
  • Class 2This type of malocclusion is also called as retrognathism or overbite. It is seen when the upper jaw and teeth severely overlaps the lower jaw and teeth.
  • Class 3This type of malocclusion is also called as prognathism or underbite. It is seen when the lower jaw protrudes forward. It is not that severe overlapping as that of overbite. But here the lower jaw and teeth overlaps the upper jaw and teeth considerably as shown in the figure.


Normally, all teeth in upper arch fit slightly over the teeth in lower arch. The points of the molars and the grooves of the opposite molar fit in each other. The upper teeth arch is slightly over the lower teeth arch to keep the cheeks and lips from being bitten from lower teeth. At the same time the lower teeth arch is little behind to protect the tongue. Malocclusion is a condition where there is some variation from this condition.

Malocclusion is mostly hereditary, i.e. a condition that is passed down through families. The difference in the size of the upper and lower jaws results in overcrowding of the teeth causing malocclusion.

Other causes of malocclusion are:

  • Birth defect conditions such as cleft lip and palate
  • Childhood habits such as tongue thrusting, thumb sucking and prolonged use of a bottle
  • Teeth abnormalities such as extra teeth, impacted teeth, lost teeth, or abnormally shaped teeth
  • Trauma or injury to the jaws
  • Misalignment of teeth after an injury or surgery of the jaws
  • Usage of ill-fitting dental crowns, fillings, retainers, appliances or braces
  • Tumors of the mouth and jaw
  • Malocclusion can be caused by crowding of the teeth. Teeth are crowded as a result of mouth-breathing or early loss of deciduous (milk or baby) teeth.

Symptoms of Malocclusion

A person having malocclusion looks quite different than a normal person. Some of the common differences or symptoms seen in the person with malocclusion are

  • Abnormal appearance of the face
  • Ups and downs in the teeth line
  • Discomfort or difficulty when biting or chewing
  • Difficulties while speaking
  • Mouth breathing that is breathing through the mouth without closing the lips.

How Malocclusion Affects Oral Health

When we eat food, the brain sends signals to the teeth to bite and grind it. The food is to be reduced to small pieces. It is followed by slowly chewing the food. This helps in easy swallowing and passage of the food through the Esophagus. It is the tube which connects the mouth to the stomach. But in a person with an irregular alignment of dental arches, the food is not bitten and grinding properly. The shapes of teeth are also different from the regular pattern. This causes dissimilar grinding of the food.

The point where the two dental arches meet is called the temporomandibular joint. There is excess pressure in these joints because of the irregular arrangements of the teeth with gaps. It also causes bits of food items to get stuck in these gaps. The shape of the tooth brush is such that it cannot reach the irregularly arranged teeth. As a result food items stuck there are not cleaned. They attract bacteria. These locations soon become sites of virus releasing foul smell causing bad breath.

Diagnosis of Malocclusion

    • Teeth Examination:Classification of malocclusion is a type of differential diagnosis of malocclusion. A dentist can discover most of the problems associated with teeth alignment during a routine examination of the teeth.
      During the examination the dentist asks the patient to pull cheek outwards. He asks the patient to bite down to check how teeth come together. If he notices any difference he goes for further diagnosis of the condition.
    • X-rays:Dental X-rays, skull or head X-rays may be required for exact diagnosis of the condition.

Treatment of Malocclusion

Malocclusion may range from minor to severe. Very less people have exact alignment of teeth. But most of them are so minor that they do not require any treatment. Malocclusion is treated by an orthodontist.

      • Positioning the teethThe goal of treatment is to correct the positioning of the teeth. Braces may be recommended. Metal bands or plastic or ceramic bonds are attached to the teeth surface. Wires or springs are also used.
      • Orthodontic proceduresIf there is crowding of the teeth, orthodontics treatment is opted. Tooth extraction, dental braces and growth modification are some of the ways in orthodontic treatment.
      • SurgeryJaw surgery or orthognathic surgery is done in extreme cases of malocclusion.

This is exhaustive information about types, causes, symptoms, effects and treatment of malocclusion of teeth. So, the next time you notice that one of your family members has the condition; you know what the necessary steps you must take.

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