What is Malocclusion? Learn About Options For How to Fix Crooked Teeth

‘Malocclusion‘ is a term that dentists and orthodontists used to refer to a misaligned bite. In other words, the definition of malocclusion is when one or more crooked teeth prevent the upper and lower teeth from coming together in a normal reposition.

This can lead to:

• Self-consciousness about the appearance of the teeth
• Difficulty chewing and eating
• Problems maintaining good oral health
• Extra pressure on certain teeth and muscles, causing strains or breakages

Fortunately, there are various malocclusion treatments and crooked teeth fixes — orthodontics — that can realign teeth into a healthier position. In this article, you'll find information about malocclusion:

• Types of malocclusion/crooked teeth
• Why people have crooked teeth
• How to fix crooked teeth with braces, veneers, or other treatments
• and how much do braces cost? 

What causes crooked teeth?

Malocclusion of teeth can occur for a number of reasons. Sometimes it's down to genetics, but certain behaviors or habits can also be causes of teeth malocclusion. Possible causes of crooked teeth include:

• Cleft palate or cleft lip
• Problems with jaw development (jaw malocclusion)
• Impacted teeth (including wisdom teeth)
• Hyperdontia or hypodontia (having extra teeth or congenitally missing teeth)
• Gingivitis (gum disease)
• Prolonged use of a bottle in childhood
• Sucking a thumb or pacifier beyond age 4
• Tongue thrusting
• Early loss of baby teeth

Should I worry about crooked baby teeth?

Baby teeth coming in crooked shouldn't be an immediate cause for concern. There are various factors that can make baby teeth crooked, and it doesn't necessarily mean that that you'll be dealing with permanent teeth growing in crooked as well.

However, if baby teeth are growing in crooked because the child has inherited a small jaw from one parent and large teeth from the other, resulting in overcrowding, it's likely they will need orthodontic work later on. If a child has gaps between their baby teeth, this is usually a good indication that they won't suffer from overcrowding with their adult teeth.

Kids with crooked teeth will find them harder to clean than straight teeth, so you'll need to pay special attention to your child's oral health.

You should start taking your child to the dentist as soon as their first tooth erupts. This not only lets the dentist monitor the growth of their teeth; it also gets the child used to having dental checkups.

What to do if permanent teeth are coming in crooked

Don't panic if your child's permanent teeth are coming in crooked; they may well straighten themselves out as they find space to grow. However, it's a good idea to take your child for regular dental checkups. If the dentist thinks your child may need braces for crooked teeth, they will refer you to an orthodontist for further assessment.

Our article on braces for kids has more information on how cases are assessed for Medicaid or the Children's Healthcare Plan (CHIP) treatment eligibility. You can also check out our guide to Medicare and Medicaid dental insurance for eligibility information. 

People with crooked teeth as adults

Many adults live their lives with crooked teeth and think nothing of it. Unless you have really crooked teeth, severe enough to affect your eating or speech, or it's causing you pain of some kind, there may not be any medical need to fix it.

But of course, it's natural to be self-conscious about a crooked teeth smile. Teeth can become more crooked over time, and it's quite common for adults to fix their crooked teeth later in life for purely cosmetic reasons.

Do pacifiers make teeth crooked?

If you have an infant, you may be wondering if thumbsucking or pacifiers cause crooked teeth. According to the ADA, thumbsucking is a natural instinct that infants and small children have to calm themselves. However, prolonged thumbsucking and pacifier use can cause baby teeth to come in crooked, and further on, permanent teeth as well, resulting in a condition called pacifier teeth. If your child is still fingersucking or using a pacifier after four years, it's time to wean them off.

Types of dental malocclusion

Malocclusion classes

Orthodontists use the following categories to define malocclusion and separate them into malocclusion classes:

• Normal occlusion: The upper and lower first molars come together normally.
• Class 1 malocclusion: The upper and lower first molars come together normally but other teeth have some crowding, rotation or other irregularities.
• Class 2 malocclusion: The upper first molar is positioned too far forward in relation to the lower first molar (resulting in an overbite).
• Class 3 malocclusion: The upper first molar is positioned too far back in relation to the lower first molar (resulting in an underbite).

Don't worry if these are a bit difficult to understand. There are other ways to categorize malocclusions and crooked teeth using more familiar terms. We have written detailed articles about each of these problems; click through on the links below to read more.

Overbite/deep bite/overjet

An overbite occurs when the upper front teeth overlap the bottom teeth too far horizontally (a deep bite) or when they stick out too far vertically (an overjet). This is one of the most common malocclusion types and can usually be corrected with braces.

Read more about overbite treatment options.

Underbite

With an underbite, the lower front teeth stick out further than the upper teeth. Around 5-10% of the population have an underbite, and correction is usually recommended.

Read more about underbite treatment options.

Crossbite

A crossbite occurs when the upper teeth sit inside the lower teeth. It may affect just one tooth or a whole row of teeth anywhere in the mouth. Malocclusion surgery may be necessary if the jaw is misaligned.

Read more about crossed bite treatment options.

Open bite

With open bite malocclusion, a gap remains between the upper and lower front teeth while the back teeth make contact when biting. This is usually caused by habits like thumb sucking and tongue thrusting. 

Read more about open bite treatment options.

Overcrowding

Overcrowding is a common cause of crooked teeth. If there isn't enough space in the jaw for teeth to erupt in the proper position, they end up rotating or overlapping. This can happen in either jaw, so you may end up with only crooked bottom teeth or crooked top teeth. 

It's sometimes necessary to remove one or more teeth to create enough space in the jaw. Some patients will need to get spacers for teeth before braces, to make sure there's enough room for teeth to straighten as well.

Gaps between teeth

Even if teeth come in perfectly straight, there may be noticeable gaps between them. The technical term for a gap between two teeth is a diastema. It most commonly occurs between the two front top teeth. 

Gaps between teeth can affect the esthetics of a smile, and also make it easier for food to get stuck. 

Read more about fixing gaps between teeth and the types of diastema.

How to fix crooked teeth

The most common crooked teeth treatment is braces. These come in many styles (you can read more about the different types of braces in our guide here), but they all work by gradually shifting the teeth into a better alignment.

Treatment with braces on crooked teeth usually takes 12-18 months, but more severely crooked teeth cases can take longer. Some teeth may need to be filed, also called Interproximal reduction, or IPR, to create more space between teeth or to even up the edges.

If you have slightly crooked teeth, or it's only your front teeth which need to be straightened, treatment may be quicker and cheaper. Certain brands of braces offer special crooked front teeth solutions designed just for this purpose. Other brands, like Fastbraces, offer a non-traditional (triangular) wire-and-bracket system to speed up treatment time.

Additionally, if you only have crooked bottom teeth or crooked top teeth, you may only need braces on the top or bottom.

On the other hand, if you have a severe malocclusion of teeth because of a misaligned jaw, you may need surgery in addition to braces to straighten your crooked teeth.

There is a possibility that your diastema will reopen after orthodontic treatment, if other factors like frenum anomaly or muscular habits have not been addressed.

How to fix crooked teeth without braces

If you're interested in fixing crooked teeth without braces, you might consider treatment with removable clear aligners. This style of brace is one of the most popular alternatives to fixed braces for crooked teeth and includes the popular brands Invisalign, NewSmile, Byte and Candid. With this sort of treatment, crooked teeth can be shifted into proper alignment without it being obvious you're undergoing orthodontic work. Many patients, especially adults, appreciate being able to remove their braces for several hours per day, too.

In-office solutions like Invisalign can work out more expensive than traditional metal braces for crooked teeth, but did you know there are cheaper options in the form of at-home aligner treatment? These let you carry out your treatment 100% remotely, making them more convenient and cost-effective.

If you're interested in treating your crooked teeth at home with aligners, you can check out the best options available below:

Can retainers fix crooked teeth?

Another possible way to straighten crooked teeth without braces is with a retainer. Retainers for crooked teeth don't have the same force as braces, so can only be used in mild cases. You'll also need to wear a retainer to avoid getting crooked teeth again after braces.

In some instances, like with crooked wisdom teeth, braces may not be needed as extraction may be the best option.

Veneers for crooked teeth in adults

You may be wondering if veneers can fix crooked teeth and if you can get veneers with crooked teeth. Veneers are a type of cosmetic dentistry for crooked teeth which can be used in mild cases of misalignment to improve the appearance of the teeth. Rather than changing the position of the teeth, a dentist can place veneers on crooked teeth to make them look straighter.

Additionally, if your teeth are still crooked after braces, porcelain veneers make be a good finishing touch for crooked teeth, especially veneers for crooked front teeth.

These tooth coverings can be applied directly using composite material, or made to measure from porcelain. Composite veneers for crooked teeth cost $250 – $1,200 per tooth while porcelain veneers cost between $500 – $2,500 each. If you're thinking about fixing crooked teeth with veneers, you can read more about this treatment and see images of crooked teeth before and after veneers here.

Bear in mind that you can only use veneers for crooked front teeth, and they aren't suitable for all malocclusion cases. The original teeth will need to be filed down slightly, meaning you can't simply remove the veneers when they fail. You'll need to get new veneers or crowns to cover the teeth again.

Dental bonding is another option for crooked teeth. Tooth bonding is similar to veneers, but is a less complicated procedure and thus less expensive.

Can you fix crooked teeth at home?

You may have heard of or seen people offering ways to fix crooked teeth at home. Although the cost savings may be appealing, you should always seek treatment from a professional. Avoid DIY options, but yes, there is a way to get treatment without ever leaving your home with at-home aligners.

Summary of malocclusion treatments

The table below shows the possible ways to fix crooked teeth, according to the type of malocclusion. The most suitable treatment for you will depend on a number of factors, so follow your dentist's advice.

Conclusion

So now you know why teeth grow crooked and how to straighten crooked teeth. Whatever type of malocclusion you have, the good news is that you don't have to live with crooked teeth and all the problems they bring.

There are various treatments which can improve your bite, the appearance of your teeth, or both. Options include braces, veneers and surgery, depending on the severity of the misalignment. Your dentist will be able to advise you on the treatment that would suit you best.