Crooked Teeth and Misaligned Bites

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• What Causes Crooked Teeth and Misaligned Bites?
• What Problems Come With Crooked Teeth and Misaligned Bites?
• How Do I Know if My Teeth Are Crooked or My Bite Is Misaligned?
• What Tests Can I Expect at the Orthodontist?
• What Treatments Fix Crooked Teeth and Misaligned Bites?

There are several reasons why some people's teeth grow in crooked, overlapping, or twisted. Some people's mouths are too small for their teeth, which crowds the teeth and causes them to shift. In other cases, a person's upper and lower jaws aren't the same size or are malformed, resulting in either an overbite, when there is excessive protrusion of the upper jaw, or an under bite, when the lower jaw protrudes forward causing the lower jaw and teeth to extend out beyond the upper teeth.

What Causes Crooked Teeth and Misaligned Bites?

Most often crooked teeth, overbites, and under bites are inherited traits just as the color of your eyes or size of your hands. Other causes of misaligned bites are early loss of baby or adult teeth; improper fit of dental restorations (for example, fillings or crowns); too small of a jaw to accommodate erupting teeth; gingivitis (gum disease); undue pressure on the teeth and gums; misalignment of jaw after severe facial injury; tumors of the mouth or jaw; or common oral health problems in children such as thumb sucking, tongue thrusting, pacifier use beyond the age of three, or prolonged use of a bottle.

What Problems Come With Crooked Teeth and Misaligned Bites?

Crooked teeth and misaligned bites can:

• interfere with proper chewing.
• make keeping teeth clean more of a challenge, increasing the reisk of tooth decay and cavities and gingivitis.
• strain the teeth, jaws, and muscles, increasing the risk of breaking a tooth.
• make people feel self-conscious about their appearance and affect their self-esteem.

How Do I Know if My Teeth Are Crooked or My Bite Is Misaligned?

Your dentist can determine if your teeth are crooked and bite misaligned through a routine examination of your mouth, teeth, jaw, and facial appearance. Your dentist will look for the following signs:

• Abnormal alignment of your teeth
• Abnormal appearance of your face
• Difficulty or discomfort when chewing or biting
• Speech difficulties, including a lisp

Your dentist will usually refer you to an orthodontist - a dentist who specializes in the diagnosis and treatment of crooked teeth and misaligned jaws.

What Tests Can I Expect at the Orthodontist?

The orthodontist will likely take X-rays, photographs of your face, and teeth impressions to determine if and what type of treatment is needed. X-rays provide information on the position of your teeth and roots and if any teeth have yet to come through the gums. Special cephalometrics or panoramic X-rays show the relationship of the teeth to the jaws and the jaws to the head. Your orthodontist may also want to take regular photographs of your face to further examine the relationship between your teeth, jaws, and head. Finally, impressions may be made of your teeth. This is done by having you bite down on a material that is later used to create an exact copy of your teeth.

What Treatments Fix Crooked Teeth and Misaligned Bites?

Once a diagnosis is made, your orthodontist can decide the best treatment for you. For some people, a removable retainer (to stabilize the new position of teeth) will be all that's needed to correct the problem. Removal of one or more teeth may be required if overcrowding is the main problem. For most people, braces are necessary to correct the problem. In rare and extreme cases, such as an extreme overbite or under bite, an operation is necessary.

Reviewed by the doctors at The Cleveland Clinic Department of Dentistry.
Edited by Charlotte E. Grayson, MD, February 2003, WebMD.

Portions of this page © The Cleveland Clinic 2000-2003

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