A Comprehensive Guide to Malocclusion | Align Braces Clinic
Malocclusion is more common than many realise, often overlooked until it begins to affect daily life. From difficulties in chewing to concerns about appearance, misaligned teeth can have wide-ranging effects on oral health and well-being.
This article breaks down what this condition is, examines its causes and consequences, and explores the orthodontic solutions available today.
Key Takeways
Malocclusion refers to the misalignment of teeth, which can affect both function and appearance.
Common types include overbite, underbite, crossbite, open bite, and overjet, each with its own set of challenges.
Causes of malocclusion include genetics, childhood habits, dental trauma, and premature loss of baby teeth.
Orthodontic treatments such as braces, clear aligners, and in some cases, corrective jaw surgery, can be employed to address different types and severities of the misalignment.
Choosing the right treatment depends on factors like age, lifestyle, bite complexity, and budget.
An orthodontist will assess your needs and specific conditions to explore suitable treatment options for enhanced dental alignment.
What is Malocclusion?
Malocclusion—or a “bad bite”— refers to the misalignment of the upper and lower teeth when the mouth is closed. While it can be mild in some cases, more pronounced forms may interfere with speaking and eating.
What Are the Different Types of Malocclusion?
There are several different types of malocclusion, each affecting the patient in different ways. These can occur individually or in combination, and the type of misalignment often influences the recommended treatment.
Some commonly seen types include:
Deep Overbite: When the upper front teeth vertically cover the lower front teeth excessively
Underbite, or Anterior Crossbite: When the lower front teeth extend beyond the upper front teeth.
Posterior Crossbite: When one or more upper back teeth bite on the inner side of the lower teeth.
Open Bite: The upper and lower front teeth do not meet when the mouth is closed, leaving a visible gap.
Increased Overjet: Increased overjet occurs when the upper front teeth protrude excessively outward over the lower teeth.
Crowding: When there isn’t enough space in the jaw for all the teeth to fit properly, causing them to overlap or twist.
Spacing: When there are noticeable gaps or spaces between the teeth, often due to missing teeth or natural jaw-tooth size differences.
Malocclusion is commonly categorised based on Angle’s classification system:
Class I: The front bite is generally aligned, but there may be spacing or crowding due to irregularities in tooth positioning.
Class II: The upper dental arch significantly overlaps the lower jaw, resulting in an overbite or excessive overjet.
Class III: The lower jaw or teeth protrude forward, causing the lower teeth to sit ahead of the upper teeth.
What Causes Malocclusion?
1. Genetic Factors
Genetics are one of the most common contributors to malocclusion. If parents have jaw discrepancies or crowded teeth, their children may inherit similar traits, increasing the likelihood of bite irregularities.
2. Childhood Habits
Prolonged thumb-sucking, pacifier use, or tongue-thrusting can affect alignment during early development. These behaviours may alter how the jaw and teeth grow, contributing to orthodontic concerns later in life.
3. Dental Trauma
Accidents involving the teeth or jaw can lead to dental alignment issues. For instance, trauma may shift a tooth out of place, resulting in a misaligned bite—particularly if the injury is not promptly treated.
4. Premature Tooth Loss
When baby teeth are lost too early, surrounding teeth can drift into the empty space. This can interfere with the eruption of permanent teeth, often causing malocclusion if not addressed with space-maintaining appliances.
Consequences of Malocclusion
1. Affects Daily Function
An irregular bite can interfere with basic functions like chewing and speaking. Chewing may become inefficient or uncomfortable, particularly when teeth do not align properly. Speech may also be affected, especially with open bites or severe overjets that alter tongue placement.
2. Negatively Impacts Self-Esteem
Visible alignment issues can influence how individuals feel about their appearance. For some, malocclusion may cause them to feel self-conscious when smiling, speaking, or eating in public. This can affect social interactions and contribute to reduced confidence, particularly in adolescents and young adults.
3. Difficulty Maintaining Oral Hygiene
When teeth are crowded, tilted, or overlapping, it becomes more difficult to clean surfaces effectively. Hard-to-reach areas can trap food particles and plaque, increasing the risk of tooth decay and gum disease. Even with good oral care habits, misaligned teeth may make brushing and flossing less effective.
4. Jaw Pain and TMJ Issues
Certain malocclusions can place strain on the jaw joints and surrounding muscles, especially when the bite is uneven or the jaws are misaligned. This may lead to discomfort or pain in the temporomandibular joint (TMJ). Common symptoms include:
Clicking or popping sounds
Limited jaw movement
Facial soreness
Headaches (particularly after long periods of speaking or chewing)
5. Leads to Future Dental Problems
If left untreated, misaligned teeth can lead to more complex problems over time, such as:
Gum recession: Uneven bite forces can cause the gum tissue to wear away, exposing the tooth roots and increasing sensitivity.
Excessive tooth wear: Misaligned teeth may experience uneven pressure and friction, leading to premature enamel wear, chipping, or flattening of the teeth.
Difficulty with dental restorations: Poor alignment can make it harder to fit crowns, bridges, or implants properly, affecting the long-term success of restorative treatments.
How Orthodontics Can Address Malocclusion
If you are experiencing these symptoms, it is advisable to consult an orthodontist. In this section, we explore how orthodontic treatment can help manage bite issues and what to consider when choosing the right approach.
Treatment Options for Teeth Alignment
Depending on the severity and type of malocclusion, your orthodontist may recommend different solutions.
1. Braces
Traditional metal braces are a common method used to correct a wide range of alignment issues, including overcrowding, gaps, and rotated teeth. These braces use metal brackets and wires to apply continuous pressure and gradually move the teeth into their ideal positions.
Braces also come in different variations, such as:
Ceramic braces: Use tooth-coloured brackets that make them a more discreet option than metal braces.
Self-ligating braces: Uses a specialised mechanism and built-in clip instead of elastic bands to hold the wire.
2. Clear Aligners
Invisalign braces are clear, removable aligners custom-made for each patient, and are often chosen by those who prefer a less visible option compared to traditional braces.
Typically changed every one to two weeks to ensure treatment progress.
Can be taken out during meals and for brushing or flossing.
However, clear aligners may not be suitable for all types of malocclusion, particularly in more complex cases.
3. Corrective Surgery
In cases of significant jaw misalignment, appliances alone may not be sufficient. Corrective jaw surgery (orthognathic surgery) may be recommended for individuals with a Class II or III skeletal (jaw) relationship, or in cases of a severe open bite. Surgery is usually combined with orthodontic treatment—such as metal braces—both before and after the procedure.
4. Combination Treatments
Some individuals require a hybrid approach to address severe malocclusion. For example, treatment may begin with metal braces for a shorter time to correct the initial misalignment, followed by clear aligners to refine the final positioning. Retainers are also used after active treatment to maintain results and prevent relapse.
Choosing the Right Orthodontic Treatment
Selecting the appropriate treatment begins with a consultation. Orthodontists are dental professionals trained in diagnosing and managing malocclusion and other alignment-related concerns. At Align Braces Clinic, patients undergo an individualised assessment to evaluate their bite, jaw structure, and oral health before discussing suitable options.
Several factors can influence your decision:
1. Age and Stage of Dental Development
Children and adolescents may benefit from early orthodontic treatment. Growth modification appliances, such as the Invisalign Palatal Expander, can help guide jaw development and create space for permanent teeth to erupt properly. Starting treatment during growth phases may reduce the need for more invasive options later.
Adults, on the other hand, may face different considerations, such as previous dental work, slower bone remodelling, or gum health issues. Treatment plans are often more customised and may involve coordination with other dental procedures, such as implants or restorations.
2. Lifestyle and Aesthetic Preferences
Treatment should align with the patient’s daily routine, professional demands, and personal preferences—especially when appearance and convenience matter.
Working professionals and students may prefer low-visibility options like Invisalign braces or Damon clear braces, which is a self-ligating option designed to be less noticeable than traditional metal braces.
Some may prioritise removability (as with clear aligners) for eating and hygiene, while others may prefer fixed options to avoid the responsibility of wearing and managing aligners daily.
3. Severity and Type of Malocclusion
The complexity of the case—whether it involves mild crowding or a more significant bite misalignment—will affect the choice of treatment. An orthodontist will assess the bite, jaw relationship, and overall alignment to determine which methods are appropriate and whether additional interventions are needed.
4. Treatment Duration and Maintenance
Orthodontic treatment using braces and clear aligners typically ranges from 1 to 3 years, depending on the severity of the malocclusion rather than the appliance used. Patient age and responsiveness to treatment may also play a role in determining the overall duration.
Clear aligners require consistent wear for 20–22 hours a day, with trays changed every 1–2 weeks to maintain progress. Missing wear time can slow down results and potentially extend treatment.
Braces are fixed appliances and do not rely on patient compliance in the same way. However, they require regular in-clinic adjustments to ensure that tooth movement stays on track.
Maintenance is also crucial throughout and after treatment. Good oral hygiene, avoiding hard or sticky foods, and following all care instructions can help prevent delays or complications.
5. Budget and Costs
Costs can vary based on treatment duration and the type of appliance used. In general, estimated costs in Singapore are as follows:
Traditional metal braces: SGD 3,500 – 5,000
Self-ligating metal braces (e.g., Damon Q): SGD 5,000 – 6000
Self-ligating ceramic braces (e.g., Damon Clear): SGD 5,500 – 7,000
Invisalign First for kids: SGD 5,000 – 6000
Invisalign Moderate-Comprehensive: SGD 6500 – 10,000
While orthodontic treatment can be a significant investment, options like student braces, flexible payment plans, and insurance can help make care more affordable for families, young adults, and working professionals. Be sure to check with your provider for a detailed cost breakdown, available subsidies, or financing options tailored to your needs.
Frequently Asked Questions
Q1: Can adults receive orthodontic treatment for malocclusion?
Yes, orthodontic treatment is suitable for patients of all ages, including adults. Options such as clear aligners and ceramic braces provide less noticeable alternatives to traditional metal braces, which may be preferred by adults who are concerned about their appearance during treatment.
Q2: How do I maintain my results after treatment?
Following orthodontic treatment, maintaining the results is crucial to prevent teeth from shifting back to their original positions. Patients are typically required to wear retainers as prescribed by their orthodontist; these can be either fixed or removable, depending on the individual’s case.
Q3: Is my child too young for orthodontic treatment?
There is no strict age limit for starting orthodontic treatment, as it depends on each child’s dental development. However, many orthodontists recommend having a first consultation by age 7. At this early stage, the orthodontist can evaluate the growth of the teeth and jaws and spot any potential issues. Treatment may not begin right away, but early assessment allows for better planning and timely intervention if needed.
Q4: Will orthodontic treatment affect my speech?
Some individuals may notice slight changes in their speech when they first start wearing braces or clear aligners. This is usually temporary, as the mouth adjusts to the new appliance. Most people adapt over time, and any speech differences often improve with practice. If difficulties continue, it is best to consult your orthodontist for further advice.
Q5: Do I always need treatment for malocclusion?
Not all cases of malocclusion require treatment. Mild misalignment may not cause any functional issues and can often be monitored over time. However, if misalignment affects chewing, speech, oral hygiene, or leads to discomfort, a professional assessment is recommended to determine whether treatment would be beneficial.
Explore Your Options with Align Braces Clinic
Malocclusion can affect more than just appearance—it may influence daily comfort, oral hygiene, and overall confidence. Whether you're considering orthodontic treatment for yourself or your child, understanding the available options is an important first step.
At Align Braces Clinic, patients can explore a range of treatment solutions, including metal braces, Invisalign, and student braces in Singapore. Our orthodontists will develop a personalised treatment plan based on individual needs, dental development, and alignment goals.
Contact us for more information today.