Malocclusion

Malocclusion is the clinical term for a "bad bite," meaning the upper and lower teeth do not align properly when the mouth is closed. It is incredibly common, with most people having some degree of malocclusion. The severity ranges from minor cosmetic irregularities to significant functional problems that affect chewing, speech, and jaw comfort.

Malocclusion is classified into three categories. Class I is the most common, where the bite relationship is normal but there is crowding, spacing, or rotation of individual teeth. Class II (often called an overbite, though the technical term is overjet when the upper teeth protrude) involves the upper jaw sitting significantly forward relative to the lower jaw. Class III (underbite) is the opposite, where the lower jaw protrudes beyond the upper jaw. Within these classes, specific issues like crossbites (where upper teeth sit inside the lower teeth) and open bites (where the front teeth do not touch when the back teeth are together) add further complexity. The causes of malocclusion include genetics, childhood habits like thumb sucking or prolonged pacifier use, premature loss of baby teeth, and jaw size discrepancies. Some cases are purely cosmetic concerns, while others contribute to real functional problems like difficulty chewing, jaw pain, abnormal tooth wear, and even speech impediments.

For your practice, documenting malocclusion during routine exams is important even if the patient is not currently interested in orthodontic treatment. It establishes a baseline, demonstrates thoroughness, and plants the seed for a future conversation. Many patients do not realize that their bite issues are treatable or that modern orthodontic options like clear aligners exist. A well-timed conversation during a routine visit can lead to a referral that significantly improves the patient's quality of life.