Your Mouth. Your Health. Our Support.

Table of contents

What Is Malocclusion: What Are The Causes & Symptoms

Malocclusion can adversely affect oral health and function. Explore the intricate details of its causes, various symptoms, and potential treatments with Flossy.

Find a Dentist near you

And save up to 50% when you book with Flossy.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
What Is Malocclusion: What Are The Causes & Symptoms

Malocclusion of teeth is a common dental problem in which the upper and lower teeth don’t align when biting down. It is a genetic condition that has several options for treatment, which depend on which type of malocclusion you have. 

In this guide from Flossy, we go over what malocclusion is, its symptoms, its causes, and which treatment options are available for it. 

What Is Malocclusion?

Dentists and orthodontists use the term malocclusion to describe when the upper and lower teeth are not aligning correctly. 

The upper teeth should land over the lower teeth only slightly when someone bites down on those without malocclusion. In addition, the upper molar teeth should fit inside the grooves of the lower molar teeth. For those with malocclusion, this isn’t the case.

Proper teeth alignment is necessary for dental health. Down the line, malocclusion can lead to dental problems, such as shifting of the teeth. Some people may also be concerned about malocclusion due to aesthetic reasons, preferring the appearance of more aligned teeth instead. 

Malocclusion is often detected in childhood. It is an incredibly common dental condition, with an approximate 50% prevalence in the U.S. In other regions, such as Europe, malocclusion can affect up to 70% of the population. 

Malocclusion is treated by orthodontists — specialists trained to diagnose and treat poorly-positioned teeth and jaws. Many patients have malocclusion identified by their regular dentists and receive a referral to a specialist because visits to orthodontists are not routine. 

What Are the Different Types of Malocclusion?

There are different ways that malocclusion can manifest, determining which class of malocclusion it is. There are roughly three classes of malocclusion: 

  1. Class 1 Malocclusion: This is the most common type of malocclusion. The top teeth slightly overlap the lower teeth; however, the overall bite is mostly normal.
  2. Class 2 Malocclusion: This type of malocclusion happens when the upper jaw and teeth severely overlap the bottom jaw and teeth. 
  3. Class 3 Malocclusion: This type of malocclusion occurs when the lower jaw protrudes forward and overlaps the upper jaw and teeth.  

Malocclusion can be further categorized into the following types, which determine which treatment will be needed to fix it:

  • Overcrowding: This type of malocclusion occurs when there is insufficient space in the jaw to accommodate developing teeth, causing the teeth to become crooked. 
  • Overbite: This type of malocclusion occurs when the upper jaw and teeth extend beyond the lower jaw and teeth. This condition can result in problems with eating and speech. 
  • Underbite: This type of malocclusion happens when the lower jaw and teeth protrude severely. It can lead the upper teeth to hit the lower gums when biting down. 
  • Crossbite: This happens when the upper teeth come down inside the lower teeth when biting down. It can happen to the front or back teeth.
  • Open bite: With this type of bite, the teeth do not come together when biting down, leaving a gap between the upper and lower teeth. 
  • Spacing: In this type of malocclusion, there are open spaces between the teeth. Missing teeth can cause this, teeth that are too small or impacted teeth (those that are “stuck” in the gums).

What Are the Symptoms of Malocclusion? 

Malocclusion can also present with the following symptoms: 

  • Difficulty biting or chewing
  • Mouth breathing 
  • Speech difficulties (this is rare)

In most cases of malocclusion, a patient’s appearance will be the primary symptom of the condition. Whether it’s an overbite, an underbite, or an open bite, a patient — and those around them — should be able to tell that their jaw and teeth position is abnormal. 

In many cases, malocclusion does not present any symptoms at all. For this reason, many patients do not know that they have the condition until a dentist identifies it. This is another reason why routine dental visits are so important. 

What Are the Effects of Malocclusion?

  • Your teeth can bump against each other
  • It is uncomfortable
  • It can lead to temporomandibular joint (TMJ) disorder
  • It makes people feel insecure

If a malocclusion is left untreated, it can lead to several health problems down the line.

Your Teeth Can Bump Against Each Other

Depending on the type of malocclusion, the teeth may bump against each other when biting or chewing, causing the protective outer layer of the teeth (called enamel) to wear away. For this reason, malocclusion is associated with an increased risk of dental problems such as tooth decay, tooth loss, and gum disease. 

Malocclusion Is Uncomfortable

Malocclusion can also be incredibly uncomfortable. For instance, those with an open bite often have difficulty chewing their food since their front teeth do not come together when biting down. 

Malocclusion Can Lead to Temporomandibular Joint (TMJ) Disorder

In some cases, malocclusion can lead to the development of a temporomandibular joint (TMJ) disorder. This condition affects the jaw joints and the muscles and ligaments in the jaw. TMJ can lead to severe pain and make it difficult for someone to move their jaw properly. 

Malocclusion Can Make People Feel Insecure

Last, malocclusion can make someone insecure about their appearance. Studies show that those with an underbite, overcrowding and spacing were most likely to experience low self-esteem. This can increase someone’s risk of developing a mental health disorder, such as depression or anxiety. 

What Are the Causes of Malocclusion?

  • Genetics
  • Birth defects
  • Losing a permanent tooth

Genetics Can Lead to Malocclusion

Malocclusion is mainly a genetic condition that’s passed down through families. If someone’s parent or grandparent has an abnormal jaw or tooth size, they will also be likely to experience it.

Birth Defects Can Cause Malocclusion

However, it is also possible for birth defects — such as cleft palate — to lead someone to develop malocclusion. Jaw fractures and tumors are another reason why someone can develop malocclusion. 

Suppose someone habitually sucks their thumb or pushes their tongue against the front teeth. In that case, they can cause their upper teeth to protrude forward over time, greatly increasing the chances of developing malocclusion. However, this mostly affects children under three years of age. 

Losing a Permanent Tooth Malocclusion

Last, losing a permanent tooth increases someone’s chances of developing malocclusion. Unless a dentist places something to fill in the gap — such as a dental bridge or dental implant — the surrounding teeth can shift and cause jaw misalignment. 

How Is Malocclusion Diagnosed?

Malocclusion must be diagnosed by a dentist or orthodontist. Several diagnostic tools are available for this, such as:

  • Dental X-rays
  • Digital scans of the teeth
  • Dental impressions (models of the teeth made using a type of dental plaster)

When dentists diagnose malocclusion, they must refer their patients to an orthodontist for treatment. However, some patients may suspect they have malocclusion and make an appointment to see an orthodontist for diagnosis.

When meeting with a dental professional about malocclusion, it’s important to understand your condition. You should come prepared with a list of questions to ask, which can include:

  • What type of malocclusion do I have?
  • Do I have any other dental problems?
  • What treatment do you recommend for me?
  • Can I get a second opinion?
  • Do I need braces? If so, how long will I have to wear them?
  • Is there an alternative treatment to braces?

Asking the above questions will ensure that you are well-informed about your condition and feel comfortable proceeding with your orthodontist's treatment. 

How Is Malocclusion Treated?

Some treatments offered may include: 

  • Braces: This is one of the most common treatments for malocclusion. Braces can be metal or ceramic, which greatly impacts their appearance. For those who do not like the look of braces, orthodontists may recommend aligners (clear braces).
  • Tooth reshaping: If the shape of the teeth is problematic, they can be reshaped to either make them smaller or larger. Dental crowns may also be recommended.
  • Tooth extraction: If there is significant overcrowding, one or more teeth can be removed to make space for the surrounding teeth.
  • Surgery: In cases of severe jaw abnormalities, surgery may be necessary. Depending on what's necessary, the jaw can be reshaped to be either shorter or longer.

The treatment that an orthodontist will recommend largely depends on the type of malocclusion you have. In addition, an orthodontist will consider your age, history of medical issues, general health, and severity of your condition. 

Your orthodontist will also ask about your preferences for treatment. For instance, some adults may not wish to wear braces to treat their malocclusion.

Treatment may extend over the course of several sessions. For instance, if the problem is overcrowding, your orthodontist may do an extraction during the first visit and put on braces during the second visit. Frequent follow-up appointments may be needed, as well.

The Treatment Time for Malocclusion Depends on Several Factors 

Treatment time for malocclusion depends on the following factors:

  • The severity of the condition
  • The health of the teeth, gums, and jaw
  • Adherence to aftercare instructions

It can take several years for the teeth to realign. However, this depends on which treatment you’re undergoing. For instance, if your orthodontist gives you braces, you might be required to wear them for 1-2 years until your teeth straighten out. 

After wearing braces, you may be wearing retainers for several more years. However, treatments such as tooth reshaping provide immediate results.

In general, teeth alignment problems are easier to fix when addressed early. Children and adolescents experience the best outcomes because they have softer jawbones, which are easier to reshape. In addition, it is easier to remove deciduous teeth — or baby teeth. 

Because permanent teeth will replace them, they will not require a dental implant in their place. 

Can Malocclusion Be Prevented?

For the most part, malocclusion is hereditary and cannot be prevented. However, in other cases, preventing certain habits can go a long way in reducing the risk of malocclusion.

For instance, malocclusion can be prevented in children by stopping them from thumb sucking. In addition, malocclusion should be diagnosed as early as possible in children — as waiting too long can lead to more severe problems.

In adults, losing teeth can cause malocclusion. For this reason, getting a dental implant or dental bridge to fill in the space of missing teeth is important. 


Teeth misalignment is a very common dental condition. In most cases, the teeth and jaw misalignment can be minor and not require treatment. However, in other cases, the misalignment can be severe and lead to physical and mental health problems.

If you suspect that you have malocclusion, getting prompt treatment is necessary for optimal dental health.

Flossy can connect you with a low-cost orthodontist in our vetted network of dental professionals. Make your appointment with Flossy today.

Our Sources: 

Worldwide Prevalence of Malocclusion in the Different Stages of Dentition: A Systematic Review and Meta-Analysis

Effect of Malocclusion on the Self-Esteem of Adolescents | NCBI

Orthodontic Treatment of Malocclusion and its Impact on Oral Health-Related Quality of Life | PMC

As Featured In

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.