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

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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.

child with crooked teeth
Do you or your child have crooked teeth?

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 that can realign teeth into a healthier position. In this article, you'll find information about malocclusion: its meaning, the types of malocclusion/crooked teeth, why people have crooked teeth, and how to fix crooked teeth with braces, veneers, or other treatments. 

What causes crooked teeth and are they genetic?

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:

Should I worry about crooked baby teeth?

child with crooked teeth
Baby teeth growing in crooked doesn't always mean crooked adult 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.

Read more about what's normal and what's not when it comes to baby teeth in our full guide here.

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

braces on crooked teeth
Adults can choose clear or invisible braces to fix malocclusion of teeth

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

Ask a dentist: Do removable clear aligners work as well as braces?

Clear aligners like Invisalign are an increasingly popular alternative to traditional metal braces. There are no brackets or wires and they should require fewer repairs and adjustments during the course of treatment than braces.

The obvious advantages to patients – especially adults – are that they are removable and less noticeable. Those perks also mean aligners are easier to clean and maintain.

Aligners may not be the best teeth-straightening solution for all orthodontic patients, however. Braces are favored in more complex situations involving severe crowding, impacted teeth, or jaw relationship correction.

Typically, the cost for aligners and braces are comparable. As with all healthcare decisions, it’s important to begin with a thorough examination and consultation with your orthodontist so that the two of you can come up with a treatment plan that makes the most sense for your individual case.

Dr. Greg Nalchajian, Nalchajian Orthodontics

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

overbite teeth with braces
Braces on crooked teeth

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.

Read more about treatments for crowded teeth.

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.

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.

crooked front teeth before and after braces
Crooked front teeth before and after braces

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.

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:

Find the right clear aligners for you
There are so many companies offering remote teeth straightening with aligners! Take a look at our top picks and discover why we recommend these over any others.
  • Advanced remote monitoring technology
  • Visit a Studio or take impressions at home
  • Monitored exclusively by orthodontists
  • $2,400 $2,100 or $79/month
Find a dentist
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Candid are leading the way in remote monitoring technology, ensuring your treatment is efficient and effective. Their orthodontist-only team follow rigorous checks when planning and conducting your treatment to give you the best results.

To get started, you can visit one of Candid's Studios for a free dental scan. Alternatively, purchase your aligner package up-front and you'll get:

  • A free impression kit
  • Free whitening foam
  • $300 off for a limited time
  • A full refund if you're not a good candidate

Finance is available from $99/month, and you can also buy just the starter kit to begin with.

Discount available for a limited time
  • Complete treatment 100% remotely
  • Amazing customer service
  • Nighttime-only option
  • $1,195 or $84/month
Find a dentist
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NewSmile aligners are made from the clearest Essix plastic and come with a daytime or nighttime-only option to suit you. For just $1,195 you'll receive everything you need to straighten and whiten your teeth – and maintain your new smile:

  • Home impression kit
  • Full aligner treatment
  • Free whitening
  • First set of retainers
  • A full refund if you're not a good fit

NewSmile go above and beyond to provide a great experience to all their customers, beginning with a live video call to help you with your teeth impressions. Mail these back, and they'll send a 3D Treatment Preview for you to approve before going ahead.

Use code DENTALYDEAL for an extra $100 off!
  • Complete treatment 100% remotely
  • Excellent customer care
  • Nighttime-only option
  • $1,145 or $95/month
Find a dentist
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If you're looking for the best value aligner package, here it is! For just $1,145 you'll get:

  • Impression kit
  • Full aligner treatment course
  • Free teeth whitening kit
  • Your first set of retainers

In short, everything needed to straighten your teeth remotely and keep them looking great, with a full money-back guarantee if you're not a suitable candidate.

This low price doesn't mean you're compromising on quality of care, though. ALIGNERCO just choose not to put so much into marketing, and they pass on the savings to their customers. They are also known for their responsive and helpful customer care, which is important when you're doing things from home.

Plus, if you're in New York, you can visit their SmileStudio for a free consultation and help taking your impressions.

Nighttime-only aligners are also available for anyone who doesn't want to wear aligners during the day.

Use code SAVE150 for an extra $150 off!
  • 3-4 month average treatment time
  • Assessed and planned by orthodontists
  • Includes whitening and first retainers
  • $1,895 or $83/month
Find a dentist
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Byte's HyperByte technology uses High Frequency Vibration to help your teeth move faster and with minimal discomfort. Their average treatment time is just 3-4 months, compared to 6 months for most others.

Treatment includes your first set of retainers. You'll also get their BrightByte 3-in-1 foam to whiten your teeth, clean your aligners and freshen your breath. And their Byte-for-life guarantee means you'll get free adjustments if your teeth start to move again.

Begin by ordering an impression kit so their orthodontists can assess whether you're a good match.

Get 75% off with code 02DENTALY100TS

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.

porcelain veneers
Veneers can fix crooked teeth in some cases

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, without seeing a dentist, for example by using elastic bands. 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.

Braces (including invisible aligners)? Surgery (in severe cases)? Veneers?
Overbite Yes Yes No
Underbite Yes Yes No
Crossbite Yes Yes No
Open bite Yes Yes (more likely for adults) Yes
Overcrowding Yes No Yes
Gaps between teeth Yes No Yes

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.

What is Malocclusion? Learn About Options For How to Fix Crooked Teeth
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Contributors:
Amanda Napitu
Amanda Napitu
Amanda Napitu on FacebookAmanda Napitu on LinkedinAmanda Napitu on Website
Amanda specialises in writing informative content about dentistry. She has been a regular contributor to Dentaly.org since 2017, and collaborates with dozens of dentists to keep this content accurate and up-to-date.
Dr. Greg Nalchajian
Amanda Napitu on Website
Dr. Nalchajian received a degree in engineering and worked as an aerospace engineer before earning his dental degree at USC and his certificate in orthodontics from the Eastman Dental Center in Rochester, NY. He frequently travels internationally to give lectures to orthodontists on practice management and treatment for the Invisalign system, helping hundreds of orthodontists improve their practices along the way.
Sources
SlideShare: Classification of malocclusion. Consulted 1st June 2019. ADA: Thumb sucking and pacifier use Consulted 20, June 2019. Invisalign: Before and After Consulted 20, June 2019.