Malocclusion is more commonly known as crowded teeth, cross bite, overbite, under bite, or open bite. It is simply the misalignment of teeth. It is a common problem seen in most people at least to some degree.

How to identify Malocclusion
Even though most people do not have perfect alignment of their teeth, for some, the misalignment causes other more noticeable problems. A dentist should be consulted if any of the following symptoms occur together with poor alignment of teeth, in order to effect a proper diagnosis and treatment of Malocclusion.

▪   pain arising from pressure to the jaw

▪   problems in speech and ability to eat

▪   breathing through the mouth

▪   difficulty in keeping the lips closed

Types of Malocclusion
In 1899, Edward Angel identified three different categories of Malocclusion:

▪   Class I Malocclusion : This is the more widespread type of Malocclusion. In this type, the first molars are normal. However the other teeth are affected by problems in spacing, crowding, and over/ under eruption.

▪   Class II Malocclusion : In this type of Malocclusion the upper molars significantly overlap the bottom teeth.

▪   Class III Malocclusion : This is the inverse of class II where the lower jaw protrudes more than the upper, causing the bottom front teeth to overlap the upper ones

Causes of Malocclusion

Malocclusion can either be inherited from parents or acquired through bad habits:

Inherited Malocclusion : This is mostly the case. This type of Malocclusion is evident in there being less or more teeth, or space between the teeth, than appropriate. It is caused by irregular jaw size or shape or by unusual formations like cleft palates.

Acquired Malocclusion : A major cause of acquired Malocclusion is bad habits. The bad habits that children mostly succumb to, such as thumb/ finger sucking or tongue thrusting, are causes of Malocclusion. As such, monitoring of such bad habits by the parents and controlling the same can easily prevent this type of Malocclusion occurring.

Treatment of Malocclusion

▪   Use of Braces

▪   Malocclusion is commonly treated by using dental braces. The constant and gently pressure provided by braces will enable teeth straightening and help push teeth back to their correct position.
Braces consist of brackets that are fixed to the teeth, and wires that connect the brackets. Since the braces cannot be removed, extra attention should be paid in keeping the teeth clean and getting rid of food particles that are likely to get stuck in the braces.

▪   Removal of teeth

▪   This will help in instances of overcrowding, where it would make room for the other teeth to move to the correct position.

▪   Reshaping, and bonding or capping teeth

▪   This will treat rough or irregular teeth removing resistance in forming a proper bite.

▪   Surgery : Requirement of surgery is rare. Surgery can be used to reshape the jaw or to stabilize the jawbone through wires, plates or screws where required. 
Malocclusion can be treated in the majority of cases. Consulting a dentist early when Malocclusion is suspected can ensure the proper and effective treatment, which would help in maintaining proper dental health.

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A great article by Steven Brazis

Who Needs Dental Implants?
By Steven Brazis
Over the past twenty years, dental implants have been constantly improving. The science and technology for dental implants now makes implants as predictable and reliable as more traditional dental restorative procedures like crowns and bridges.

Implants are done in two distinct stages. A titanium artificial tooth root is surgically placed into the jaw bone by an oral surgeon, periodontist or general dentist with specialized training. The top of the implant is just below the level of gum tissue and exposed to the inside of the mouth by leaving a small hole in the gums. A “healing cap” is screwed into the threads of the implant to prevent the gum tissue from growing over or into the implant.

A period of 6 weeks to several months is required for the titanium implant to “integrate” with the jaw bone. That means that the bone actually attaches to the implant to provide stability. It should be realized that this attachment is NOT the same as with a natural tooth. There is no periodontal ligament involved, which is the feature in bone to tooth attachment that allows for tooth movement through bone. Implants cannot be moved orthodontically nor be exposed to forces that cause natural teeth to move in response. For this reason, if implants are being considered with multiple missing teeth, your dentist must plan the number of implants and type of restoration placed on the implants carefully.

The type of restoration placed on the implant are varied. In the case of a single tooth, a piece called an abutment is screwed into the implant to replace the healing cap when osseo-integration of the implant has been accomplished. A crown (or cap) is then cemented over the abutment just as if this were a natural tooth that had been prepared for a crown.

There can be several single tooth implants placed either adjacent to one another or in various locations around the mouth where teeth are missing. However, when the span of missing teeth is too great, it becomes more cost effective as well as biologically supportable to place two or three implants and link them together with a fixed bridge. There will be more teeth showing on the bridge than there are implants, just like with traditional bridges on natural teeth. These are also supported be abutments screwed into the implants as with single tooth implants.

When there are many missing teeth (or all of them) implants are usually used to support a removable denture. In these cases, several implants are linked together with a cast metal bar screwed into the implants on short posts. On the under side of the denture clips are inserted which clip onto the bar between the implants. A denture made this way is vastly more comfortable than a traditional denture because it largely rests on the bar instead of the tissue, thus eliminating many of the sore spots caused by dentures. Additionally, the denture is locked into place by the clips and is extremely stable, unlike dentures which tend to slip and shift or come completely out much more easily.

Although implants can be very expensive by comparison with other more traditional dental prosthetics, the potential benefits make them equally valuable. Most patients who have had traditional dental prosthetics replaced by implant supported prosthetics are so happy that they would never go back.

Dr. Steven Brazis has practiced family and cosmetic dentistry for 35 years. His practice is in Sacramento, CA. He has written extensively on dentistry for the lay person.

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Look at all the great smiles here! I’m telling you everyone had such great teeth – but here I am thinking like a dentist…  We work hard but we have a lot of fun too – and Sullivan’s was such a perfect venue for this fund raiser. I think everyone had a good time and we met a lot of great new people too! If you’re one of them, Come on in for a visit – I’d love to see you again!

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