My top and bottom teeth don t line up

A beautiful smile is not just about straight and white teeth but also about having a proper bite. Unfortunately, around 75% of the population suffers from malocclusion - a term used to describe bite issues. Malocclusions can affect daily life and can also pose long-term health risks. We will discuss the most common bite issues and the various treatment options available to correct them. We offer a personalized care approach at Lindsey Orthodontics, an Orthodontist in Griffin GA, to ensure every patient receives the best treatment possible.

My top and bottom teeth don t line up

Underbite

A lower jaw underbite happens when the lower front teeth protrude beyond the upper jaw. This occurs because the lower jaw extends further than the upper jaw, which can cause speech problems, difficulty chewing, and uneven tooth wear. Underbites are more common in males and can lead to long-term health issues like TMJ disorder and sleep apnea. Treatment options include braces, headgear, and in severe cases, surgery. Wearing braces can correct the alignment of the teeth and jaw, while headgear can help modify jaw growth. Surgery is considered only as a last resort.

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My top and bottom teeth don t line up

Overbite

The upper jaw overbite occurs when it extends too far forward, causing the upper teeth to overlap the lower teeth. This can cause cosmetic concerns and difficulties in biting and chewing. Overbites are more common in females, leading to headaches and jaw pain over time. Treatment options include braces and functional appliances, such as bite correctors and chin cups. Braces are the most effective treatment for overbites, and functional devices are used in specific cases to modify jaw growth.

My top and bottom teeth don t line up

Crossbite

A crossbite happens when one or more teeth on the upper jaw rest inside the set of teeth on the lower jaw. This misalignment can affect your bite and may require attention to ensure proper dental health. Crossbites can lead to asymmetrical jaw growth, uneven tooth wear, gum disease, and other periodontal problems. Treatment options include braces, expansion appliances, and, in some cases, tooth extraction. Braces are the most common way to correct crossbites, while expansion devices widen the jaw and correct the alignment of the teeth.

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My top and bottom teeth don t line up

Upper Front Teeth Protrusion

Upper front teeth protrusion occurs when the upper teeth extend too far forward, creating a prominent overbite. This can cause difficulties in speaking, biting, and an unattractive smile. Treatment options include braces and headgear. Braces can help straighten the teeth, while headgear can modify the growth of the jaw.

My top and bottom teeth don t line up

Crowding

Crowding occurs when the jaw has insufficient space for the teeth to develop properly, causing teeth to push against each other. This can cause uneven tooth wear and increase the risk of periodontal problems. Braces are the most common crowding treatment; tooth extraction may be necessary in severe cases.

My top and bottom teeth don t line up

Spacing

Spacing occurs when there are gaps between teeth or when the teeth are small in proportion to the jaw. Spacing can also occur as a result of missing teeth. This can cause food to get trapped, increasing the risk of gum disease. Treatment options include braces and dental implants.

We Offer Invisalign in our Griffin GA and Locust Grove GA offices

Malocclusions can significantly impact an individual's quality of life, hampering their capacity to articulate, chew, and express joy through a smile. While Invisalign and specialized orthodontic devices are the most common treatments, some cases require surgery for effective correction.

Occlusion refers to the alignment of teeth and the way that the upper and lower teeth fit together (bite). The upper teeth should fit slightly over the lower teeth. The points of the molars should fit the grooves of the opposite molar.

The upper teeth keep you from biting your cheeks and lips, and your lower teeth protect your tongue.

Malocclusion is most often hereditary. This means it is passed down through families. It may be caused by a difference between the size of the upper and lower jaws or between the jaw and tooth size. It causes tooth overcrowding or abnormal bite patterns. The shape of the jaws or birth defects such as cleft lip and palate may also be reasons for malocclusion.

Other causes include:

  • Childhood habits such as thumb sucking, tongue thrusting, pacifier use beyond age 3, and prolonged use of a bottle
  • Extra teeth, lost teeth, impacted teeth, or abnormally shaped teeth
  • Ill-fitting dental fillings, crowns, dental appliances, retainers, or braces
  • Misalignment of jaw fractures after a severe injury
  • Tumors of the mouth and jaw

There are different categories of malocclusion:

  • Class 1 malocclusion is the most common. The bite is normal, but the upper teeth slightly overlap the lower teeth.
  • Class 2 malocclusion, called retrognathism or overbite, occurs when the upper jaw and teeth severely overlap the bottom jaw and teeth.
  • Class 3 malocclusion, called prognathism or underbite, occurs when the lower jaw protrudes or juts forward, causing the lower jaw and teeth to overlap the upper jaw and teeth.

Symptoms of malocclusion are:

  • Abnormal alignment of teeth
  • Abnormal appearance of the face
  • Difficulty or discomfort when biting or chewing
  • Speech difficulties (rare), including lisp
  • Mouth breathing (breathing through the mouth without closing the lips)
  • Inability to bite into food correctly (open bite)

Most problems with teeth alignment are discovered by a dentist during a routine exam. Your dentist may pull your cheek outward and ask you to bite down to check how well your back teeth come together. If there is any problem, your dentist may refer you to an orthodontist for diagnosis and treatment.

You may need to have dental x-rays, head or skull x-rays, or facial x-rays. Diagnostic models of the teeth are often needed to diagnose the problem.

Very few people have perfect teeth alignment. However, most problems are minor and do not require treatment.

Malocclusion is the most common reason for referral to an orthodontist.

The goal of treatment is to correct the positioning of the teeth. Correcting moderate or severe malocclusion can:

  • Make teeth easier to clean and decrease risk of tooth decay and periodontal diseases (gingivitis or periodontitis).
  • Eliminate strain on the teeth, jaws, and muscles. This lessens the risk of breaking a tooth and may reduce symptoms of temporomandibular joint disorders (TMJ).

Treatments may include:

  • Braces or other appliances: Metal bands are placed around some teeth, or metal, ceramic, or plastic bonds are attached to the surface of the teeth. Wires or springs apply force to the teeth. Clear braces (aligners) without wires may be used in some people.
  • Removal of one or more teeth: This may be needed if overcrowding is part of the problem.
  • Repair of rough or irregular teeth: Teeth may be adjusted down, reshaped, and bonded or capped. Misshapen restorations and dental appliances should be repaired.
  • Surgery: Surgical reshaping to lengthen or shorten the jaw is needed in rare cases. Wires, plates, or screws may be used to stabilize the jaw bone.

It is important to brush and floss your teeth every day and have regular visits to a general dentist. Plaque builds up on braces and may permanently mark teeth or cause tooth decay if it is not properly removed.

You will need a retainer to stabilize your teeth after having braces.

Problems with teeth alignment are easier, quicker, and less expensive to treat when they are corrected early. Treatment works best in children and adolescents because their bones are still soft and teeth are moved more easily. Treatment may last 6 months to 2 or more years. The time will depend on how much correction is needed.

Treatment of orthodontic disorders in adults is often successful, but may require longer use of braces or other devices.

Complications of malocclusion include:

  • Tooth decay
  • Discomfort during treatment
  • Irritation of mouth and gums (gingivitis) caused by appliances
  • Chewing or speaking difficulty during treatment

Call your dentist if toothache, mouth pain, or other new symptoms develop during orthodontic treatment.

Many types of malocclusion are not preventable. It may be necessary to control habits such as thumb sucking or tongue thrusting (pushing your tongue forward between your upper and lower teeth). Finding and treating the problem early allows for quicker results and more success.

Crowded teeth; Misaligned teeth; Crossbite; Overbite; Underbite; Open bite

Dean JA, Walsh JS. Managing the developing occlusion. In: Dean JA, ed. McDonald and Avery's Dentistry for the Child and Adolescent. 11th ed. St Louis, MO: Elsevier; 2022:chap 23.

Dhar V. Malocclusion. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 335.

Hinrichs JE, Thumbigere-Math V. The role of dental calculus and other local predisposing factors. In: Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds. Newman and Carranza's Clinical Periodontology. 13th ed. Philadelphia, PA: Elsevier; 2019:chap 13.

Koroluk LD. Adolescent patients. In: Stefanac SJ, Nesbit SP, eds. Diagnosis and Treatment Planning in Dentistry. 3rd ed. St Louis, MO: Elsevier; 2017:chap 16.

Nesbit SP, Reside J, Moretti A, Gerdts G, Boushell LW, Barrero C. Definitive phase of treatment. In: Stefanac SJ, Nesbit SP, eds. Diagnosis and Treatment Planning in Dentistry. 3rd ed. St Louis, MO: Elsevier; 2017:chap 10.

Updated by: Michael Kapner, DDS, General Dentistry, Norwalk Medical Center, Norwalk CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Is it normal for top and bottom teeth to not align?

Your jaw is constantly growing and changing, so it's not unusual for your teeth to shift over time. However, leaving your teeth misaligned can lead to bite problems, jaw pain, and even overall health issues. It's best to fix your teeth before a bad problem becomes worse.

How do you fix teeth that don't line up?

Metal Braces One of the most common and oldest treatments for misaligned teeth is the use of metal braces to straighten the teeth.

Should your top and bottom teeth be in line?

Your teeth are supposed to line up so you can chew food with ease. When they don't line up, it can put extra pressure on your teeth and jaw. If you often have discomfort while chewing, and it isn't coming from other dental problems like tooth decay, you may have a malocclusion.

Can misaligned teeth be fixed?

Braces. Braces are the most common treatment option used to treat severe misalignment of the teeth and jaws. This dental device consists of metal bands that are usually placed on the back teeth. Small metal squares called brackets are adhered to each tooth and a wire is placed in the bands and run through the brackets.