Malocclusion | Overview
Malocclusion refers to any degree of irregular contact of the teeth of your child's upper jaw with the teeth of the lower jaw. This includes overbites, underbites, and crossbites, as well as crowding of your child's teeth.
While about 90 percent of school-aged children have some degree of malocclusion, only about 10 to 15 percent of these have severe malocclusion that requires treatment. Most children seek treatment of malocclusion for cosmetic — rather than medical — reasons.
What causes malocclusion?
There is no one single cause of malocclusion. Many different factors are involved, including genetic factors and/or environmental factors.
- Children who suck their thumbs or fingers beyond the age of 5 have an increased chance of developing malocclusion.
- Children with a very small space between their baby teeth are at risk for having problems with malocclusion when their permanent teeth appear, because the permanent teeth are larger and require more space.
How is malocclusion diagnosed?
Malocclusion is usually diagnosed based on a complete history and physical examination of your child and your child's mouth.
Your child's physician will probably refer the child to a dentist or an orthodontist for complete evaluation and treatment. The following tests may also be done to help evaluate the problem:
- x-rays: a diagnostic test that uses invisible electromagnetic energy beams to produce images of your child's mouth and teeth on film
- Impressions of the teeth: plaster models of the mouth to help evaluate the malocclusion
Your child's orthodontist will decide whether your child's bite will benefit from orthodontic treatment and recommend the appropriate steps to follow. It is important to evaluate and treat many malocclusions as they may cause problems with your child's bite, gum tissue, jaw joint, speech development, and appearance.
In some cases, a specialist in jaw surgery may need to be consulted.
How is malocclusion treated?
Treatment is sometimes done in phases depending of the extent of your child's malocclusion. In some cases, we need to remove your child's baby teeth to help make room for his permanent teeth. Permanent teeth are also sometimes removed. Other treatment may include:
- jaw surgery: in some cases, your child may need jaw surgery to correct the bite problem when the bones are involved
- mouth appliances: fixed (braces) or removable (retainers) appliances that help realign your child's teeth
- It's important to have good oral hygiene while wearing these appliances. Make sure your child brushes and flosses regularly. Removable mouth appliances must also be cleaned regularly.
- The following food should be avoided while wearing any type of mouth appliance:
- sticky foods
Your child's activity may need to be restricted, based on the type of appliance that is used. You can discuss this with your child's dentist or orthodontist.
Is orthognathic (jaw) surgery right for your child?
A well-proportioned bite occurs when all of your child's upper and lower teeth are correctly aligned and he can bite together evenly. Jaw surgery corrects malocclusion that results from the underlying bone disharmony. Your child's front upper teeth should overlap slightly with his front lower teeth when he bites. If your child's jaw is not properly aligned, he may have difficulty chewing or pronouncing specific sounds clearly.
The Oral and Maxillofacial Surgery Program at Boston Children's Hospital works in conjunction with our orthodontists in the treatment of children requiring orthognathic surgery.