Tooth and jaw misalignments

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Tooth and jaw misalignments are not uncommon and a serious problem: They usually not only look unattractive, but can also promote tooth decay and periodontitis and trigger inflammation of the mucous membrane. Chewing, biting, and speaking can also be impaired. Read more about misaligned teeth and jaws here!

Congenital or acquired

There are congenital tooth misalignments and a combination of congenital and acquired causes. The most common congenital deformities include:

• excess, under-number, or misaligned teeth
• teeth that are too big or too small
• too big or too small jaw

Acquired misaligned teeth can be caused by the following factors:

• Children: Sucking and sucking on the thumb, pacifier or bottle - this can cause what is known as an "open bite". The upper and lower rows of teeth are not completely on top of one another.
• Biting or sucking on the lips
• Malfunctions of the tongue, for example the insertion of the tongue between the row of teeth when swallowing
• Premature loss of milk teeth: the neighboring milk teeth move into the gap and block the path of the second teeth to their final place.

Recognize misalignments

Certain signs indicate misalignment of the teeth and jaw:

• visible missing position (like protruding incisors)
• Problems chewing
• Temporomandibular joint pain
• Teeth that "step out of line" (e.g. due to crowding)
• Lip closure problems
• Speech defects (like lisp)
• headache
• Snoring (sleep apnea)

Determine the extent

For the dentist or orthodontist, premature or delayed tooth eruption, misaligned teeth and conspicuous forms of jaw misalignment can already be recognized by looking into the mouth. For an exact orthodontic diagnosis, however, special examinations, measurements and evaluations are required:

A panoramic x-ray reveals whether all teeth are correctly positioned or positioned and whether there are excess or displaced tooth germs.

Usually a cephalometric x-ray of the skull is also made. It shows the entire facial skull from the side. This allows the size, shape and direction of growth of the upper and lower jaw to be determined. In addition, it can be seen whether the incisors are correctly aligned and in which position the chin is. These parameters are particularly important for a harmonious facial contour.

Impressions of the upper and lower jaw show the extent of the misalignment: A model of the teeth is made and precisely measured.

The smooth interaction of the entire chewing system is also checked: Do teeth, jaws, muscles and temporomandibular joints complement each other optimally? A functional analysis brings clarity. Important parameters here are the position and movements of the tongue, the function of the temporomandibular joint, the fit of the rows of teeth and breathing through the mouth or nose. Existing language difficulties and the tendency to ear, nose and throat diseases are also carefully examined.

The most common misalignments

Crowded teeth	The newly erupting teeth have too little space in the jaw arch, they grow slightly twisted and offset. The reason: the teeth are too big or the jaw is too small. Crowded teeth are usually congenital. Too early loss of milk teeth due to poor oral hygiene in toddlers and tooth changes in adulthood are other possible causes. Natural remodeling processes in the lower jaw lead to crowding in the lower jaw in almost all adults in the course of their lives.
Overbite (prognathy)	The upper incisors protrude too far above the teeth of the lower jaw. The cause can be an overdeveloped upper jaw or an underdeveloped lower jaw. However, the teeth can also tip forward due to incorrect habits.
Reverse overbite (progeny)	The lower jaw is more developed than the upper jaw and protrudes further forward. A protruding chin can be the outward sign of this. In extreme cases, the lower incisors bite before the upper ones.
Deep bite	When clenching, the upper front teeth cover those in the lower jaw. Usually the upper teeth only cover about a third of the lower teeth. The deep bite may be so pronounced that the lower front teeth bite into the palate.
Open bite	The teeth gape apart when the rows of teeth are closed. There is a clear, often circular gap between the teeth of the upper and lower jaw. The open bite can occur in the anterior or posterior teeth.
Crossbite	Some of the lower jaw teeth protrude laterally over the teeth of the upper jaw.
Diastema	There is a visible gap between the incisors (especially in the upper jaw). The cause can be a lip frenulum that is too deeply attached (congenital), which prevents the incisors from advancing to the midline. The lip frenulum is a small fold of the mucous membrane that connects the lips and the gums in the oral cavity.
Displaced teeth	Often canine or wisdom teeth do not erupt in the right place during development. However, they can also remain completely in the jawbone (retained teeth). For example, a canine tooth can lie in the palate bone.

Misalignments - what to do?

Not every tooth and jaw misalignment needs to be treated orthodontically (e.g. with braces). This is medically absolutely necessary only in the case of clear misalignments and if increasing deterioration in terms of aesthetics, dental health and chewing function is to be expected in the future.

The treatment of misaligned teeth and jaws belongs in the hands of specialists - orthodontists or dentists.

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