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A malocclusion is an abnormal structure of the jaws that interferes with the functioning of the oral cavity - it can, for example, cause distortion of speech, difficulty breathing or eating. It manifests itself in childhood and already then preventive measures should be taken to prevent further complications. Many malocclusions can be reduced or significantly corrected.

Malocclusionis diagnosed in more than half of children aged 7-18. - Research shows that over 90% of Poles suffer from them, and every second of them should receive orthodontic treatment. However, not all malocclusions can be cured by an orthodontist. More and more cases go to maxillofacial surgeons - says Rafał Nowak, MD, PhD.

Occlusal defects may result from abnormalities in the structure and position of the jaw bones in relation to each other or from a disturbed arrangement of the dental arches. Often a malocclusion is a congenital trait, resulting from hereditary or external factors that affect the fetus through the mother's body, such as certain medications and vitamins. It also happens that a child can "spoil" his bite with bad habits, such as persistent thumb sucking.

Malocclusion - causes

The factors that lead to the formation of a malocclusion are:

  • forceps, facial
  • incorrectly positioning the baby to sleep - the head and neck should be on a gentle elevation when sleeping on the side
  • incorrect latching on to the breast or bottle-feeding (both the breast and the bottle should be served at an angle of 45 degrees, - some parents feed the child lying flat on its back, which causes and consolidates a back bite, because the child's jaw drops)
  • thumb sucking or poorly constructed pacifier
  • sucking lips and cheeks
  • biting on various objects, e.g. crayons, pencils
  • breathing through the mouth (third almond)
  • teeth grinding (bruxism)

What do malocclusion lead to?

Depending on the severity of the malocclusion, it may have a varying degree of influence on life activities, as well as on the psychological comfort of a person. Severe bite defects disrupt speech (causing, for example, lisping), breathing and eating. Gnawing bites of food and chewing can be both difficult and embarrassing for someone with an abnormalbite - it can cause mental problems, such as reluctance to eat in public.

It happens that a malocclusion disturbs even the symmetry of the face - e.g. excessive protrusion or withdrawal of a chin. Untreated malocclusions can lead to a number of unpleasant consequences, such as periodontal disease, tooth decay, chipped teeth, damage to the mucosa of the lips and cheeks by constant biting.

- The jaw bones and the mandibular bones may be overdeveloped, underdeveloped, or placed in abnormal relationships to each other. It all affects the appearance of the face, because it is visible in the disturbed aesthetics of soft tissues. Such causes, however, can be removed by appropriate surgical treatment - emphasizes the drug. stom. Szymon Przywitowski, specialist in maxillofacial surgery at Medicus Clinic.

Types of malocclusion

  • Overshot mouth- the most common malocclusion, accounting for about 70% of all malocclusions. The lower dental arch is set back in relation to the upper one, with the front teeth not in contact. In severe forms, the upper incisors may be inclined towards the upper lip, and the face may be distorted by retracting the lower jaw and lowering the corners of the mouth. The pronunciation of the sounds s, z, c, dz, due to the separation of the teeth, resembles ś, ź, ć, j.
  • Deep bite- the upper teeth extend very deeply over the lower teeth, covering 2/3 of their height. This causes the face to lose symmetry by shortening the lower segment. Teeth arranged in this way wear excessively, so it is imperative to correct this defect to minimize dental problems, gums and periodontitis. In this malocclusion, there is also a distortion of the dentalized sounds.
  • Overshot bite- the lower dental arch overlaps the upper one. The facial features show the protrusion of the chin and lower lip forward. The appearance of a menacing expression on his face is created.
  • Cross bite- lower teeth overlap upper teeth in some sections or in the entire dental arch
  • Open bite- teeth do not touch each other at all. The clearance that creates is called an under-bite gap. This malocclusion will make it very difficult to chew on bites of food and chew, as well as to correct pronunciation - especially the frontal-dental consonants (t, d, s, z, dz, c, n, ł). Open bite causes elongation of the face, underdevelopment of the jaw, reduced tension in the muscles of the lips and tongue, and the chewing muscles, high palate, the so-called gothic palate.
  • Crowding- too large teeth in relation to the alveolus. Because in the maxilla and the mandible there is no forplaces, they grow up rotated, at the wrong angle, in the wrong places (clutter effect)
  • Separated teeth- excess space in the maxilla and mandible causes visible gaps between the teeth

When to see an orthodontist

Even if we think that everything is fine, it is worth enrolling your child in an orthodontist prophylactically as soon as all milk teeth grow up.

Orthodontic treatment can also be performed in adults, and even in the elderly. Sometimes the bite needs to be corrected before adjusting the denture.

The specialist will assess whether our child's bite is developing properly, and if not, he or she will establish a further plan of action. The visit to the orthodontist should not be postponed, if we notice any signs of an abnormal bite in the child, or if the child grinds his teeth, breathes his mouth, has some tongue dysfunction, bites his nails, has lost his milk teeth prematurely. If we respond in time, treatment will be available quickly. Usually, it begins when the child has all permanent teeth, i.e. around 11 years of age, and should be completed within 1.5-2.5 years, although it depends on the severity of the defect, the patient's age and his involvement in treatment. .

Treatment of malocclusion in an orthodontist

Incorrect bite can be treated with myotherapy, i.e. exercises for the mimic muscles and the masticatory organ, and with orthodontic appliances. In some cases, maxillofacial surgery may need to be considered. The apparatus is made individually for each patient. Sometimes you first need to take an X-ray of the teeth and a plaster cast.

There are two basic types of orthodontic appliances:

  • permanent - attached to the teeth for two years
  • movable - worn for several hours during the day or, for example, for the night.

Malocclusion - surgical treatment

When is surgery necessary? This is one of the most frequently asked questions in orthodontic offices. In order to answer them, it is first necessary to diagnose what type of malocclusion we are dealing with. It depends on the diagnosis whether we should visit an orthodontist or a maxillofacial surgeon, how long it will take to remove the defect, by what method and what the treatment effect will be. In addition, it should be remembered that skeletal defects require close cooperation between the orthodontist and the maxillofacial surgeon, because none of them alone can effectively solve the patient's problem.

- Common defects are successfully treated in orthodontic offices. Disadvantages are a more complex problemframework, and here we are already delving into other kinds of aspects. A skeletal defect occurs when the bone bases in which the teeth are placed are not properly developed. Such defects in the facial bones require interdisciplinary orthodontic and surgical treatment in order to effectively eliminate them - says Dr. Rafał Nowak.

Orthognathics as a branch of maxillofacial surgery deals with the diagnosis and surgical treatment of malocclusion resulting from abnormal development of facial bones. In simplified terms, orthognathic surgery is needed where orthodontics is no longer sufficient. The craniofacial defects can include the mandible and the jaw, as well as other bones that build the facial skeleton. The procedure is performed inside the mouth under general anesthesia.

Surgical treatment of malocclusion is a chance to improve the appearance of the face and the comfort of life. It is worth taking care of appropriate treatment, especially since not only aesthetic, but above all he alth aspects are involved.

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