8 Common Bite and Teeth Misalignments (& How To Treat Them)

Whether it’s a small gap between teeth or a severe crossbite, the truth is that few people have a perfectly aligned smile. If you’re one of many adults bothered by a dental misalignment and searching for a teeth-straightening solution, you’re in luck.

These days, there are more teeth-straightening options than ever and many are more affordable than you think. However, some are better suited than others for particular conditions, so it’s important to understand your options before jumping in. This guide breaks down the most common types of dental misalignments (or “malocclusions”) and highlights popular treatment options for each condition.

Common Types of Dental Misalignments

You might recognize that your teeth aren’t straight when you look in the mirror, but do you know the name of your bite problem? Here’s some helpful info about the most common conditions.

Crowding

Dental crowding occurs when there isn’t enough space to accommodate all your teeth, causing them to overlap or rotate.^{[ 1 ]} It’s a very common condition and one that’s easily corrected.

In most cases, crowding doesn’t present a serious medical concern, although it can accelerate plaque buildup and tooth/gum decay since it makes brushing and flossing more difficult. Most times, teeth crowding is an easy fix for braces, Invisalign, and at-home aligners (provided your case isn’t too severe).

Crowding can be fixed a few different ways. It can be fixed with braces, Invisalign, at-home aligners, or veneers. Which is the right choice? There are a few factors to consider. Orthodontic treatment requires a time commitment but may end up costing less in the long run, depending on the number of veneers you need.

Braces can make proper oral hygiene more difficult. Clear aligners are more likely to get misplaced. Veneers, while they can be done in as little as one visit, may require some tooth structure to be removed so they aren’t too bulky. Veneers are also not as permanent as undergoing orthodontic treatment and may need to be redone a few times over the course of your life.

Spacing

Dental spacing, also called diastema,^{[ 2 ]} is extremely common and very treatable. You probably already guessed that this condition consists of gaps between one or more teeth. It’s primarily a cosmetic concern, but in severe cases, it can cause difficulty chewing, speech impediments, increased plaque buildup between teeth, and jaw pain.

Spacing can be caused by missing teeth, a healthy jaw that’s growing (like in children), natural growth discrepancies like being born with a jaw that’s larger than the teeth, or something more serious like gum disease.

Another common spacing issue is a gap between your front teeth. This is called a maxillary midline diastema.^{[ 3 ]} A maxillary midline diastema is rarely a medical concern, and many people live their whole lives with a tooth gap between their front teeth. This particular gap can be caused by the frenum^{[ 4 ]} being attached too high or too low. The frenum is a small piece of tissue that connects your top lip to your gum in the center of your mouth.

It’s typically pretty easy to correct spacing using braces, Invisalign, or at-home teeth aligners. Depending on the severity of the gap, veneers or dental bonding might be viable options too.

Midline Misalignment

Also called midline discrepancy or deviated midline,^{[ 5 ]} this is when your teeth are slightly off-center. Unless it’s coupled with a bite issue, a midline misalignment isn’t a huge cause for concern. But if it bothers you, getting braces, Invisalign, or at-home aligners (for cases not caused by jaw misalignments) can help correct it.

Overbite

Overbite^{[ 6 ]} is a jaw misalignment rather than a teeth misalignment. It occurs when the top teeth extend too far in front of the bottom ones. Minor overbites don’t often present any serious complications, but more significant ones can cause enamel damage, jaw discomfort, headaches, and more.

Many overbites develop as a child grows. Thumbsucking and pacifier use past the age of three can contribute to an overbite. It can also be caused by genetics and teeth grinding that places constant pressure on the teeth, causing them to shift.

If left untreated, a moderate to severe overbite can cause jaw pain, difficulty chewing, speech problems and even breathing issues.

An overbite typically requires in-office treatment. Depending on the cause of the overbite, a device called a palatal expander might be recommended for children before traditional braces or Invisalign is recommended. At-home aligners are usually not recommended for this level of overbite but may be suitable for adults with minor overbites. In very extreme cases, surgery may be recommended for an adult with an overbite.

Underbite

Underbite^{[ 7 ]} is another jaw misalignment, one that occurs when the bottom front teeth extend beyond the front top teeth, causing a bulldog-like appearance. Underbites can be both tooth-related or jaw-related. Sometimes, cases of underbite are mild, while other times, they can cause difficulty chewing, enamel erosion, headaches, jaw discomfort, and more.

An underbite can be hereditary or caused by childhood habits like thumbsucking.

Treating an underbite depends on the cause. If the issue is skeletal and involves the jaw, then acting as quickly as possible while the child is young and still has some baby teeth is the best course of action. Minor cases of an underbite that aren’t related to the development of the jaw bone can be treated with clear aligners. In extreme cases, jaw surgery followed by braces might be the only solution for a healthy bite.

Crossbite

A crossbite^{[ 8 ]} occurs when one or more of the top teeth fit into the bottom teeth. It’s as if the bite is reversed. There are two types of crossbite: anterior (front teeth) and posterior (back teeth). A normal posterior bite has the center of the top teeth resting inside the center of the bottom teeth. A crossbite is when the opposite happens. If you have an anterior bite, then one or more of your top front teeth rest behind your bottom front teeth. The symptoms and treatment for this condition are varied, based on which teeth it affects.

Sometimes, crossbite is a dental issue caused by misaligned teeth, while other times, it’s skeletal, stemming from a jaw malocclusion. Untreated crossbites can cause lopsided jaw growth, tooth pain, enamel erosion, and jaw pain.

Dental crossbites can respond well to various treatments, including braces, Invisalign, and home aligners. If a child has a crossbite, their doctor might recommend a palatal expander to help the top jaw grow a bit faster before proceeding with braces or clear aligners.

Overjet

An overjet^{[ 9 ]} is when the teeth stick out and sit over the bottom teeth. It can also be called “buck teeth.”  An overjet is often confused with overbite^{[ 10 ]} because they’re both characterized by front teeth that protrude too far over the bottom ones. The difference is that in cases of overjet, the teeth protrude out and not down, like in cases of overbite.

Overjets can be hereditary or caused by thumb-sucking, pacifier use or a tongue thrust,^{[ 11 ]} which is caused by the tongue pushing too far forward in the mouth.

Like overbite, it’s possible to live with overjet, but it might cause difficulty chewing, increased enamel wear, and accelerated tooth and gum decay. At-home aligners can only treat overjet cases that are purely dental. Cases of jaw misalignment usually require the more robust, in-office care of braces or Invisalign.

Open Bite

There are two types of open bite.^{[ 1 ]} An anterior open bite occurs when the back teeth come together properly, but the front teeth don’t overlap. A posterior open bite is the opposite: the front teeth come together, but the back teeth don’t touch. Open bites can be dental, skeletal, or the result of thumbsucking, TMJ disorders, or tongue thrust.^{[ 12 ]} Even though they don’t present immediate dental concerns, an open bite can cause jaw pain, difficulty chewing, and speech issues.

Minor cases involving just the teeth can be easily fixed with clear aligners, whereas cases caused by skeletal or jaw issues can typically only be corrected by an in-office treatment like braces or Invisalign. If your child is young enough and the cause is a result of thumb-sucking or pacifier use, simple behavior modification might be all that is needed.

When To Get Treatment

Plenty of adults live with dental misalignments every day and have perfectly happy lives. However, certain conditions, when severe, can eventually lead to uneven wear and tear, advanced tooth decay, and gum disease. And others might rob you of your confident smile.

There are three major reasons you might want to seek treatment. First, if your condition is causing you physical discomfort. Second, if your condition is severe and you’re worried about its potential effects down the road. And third, if it makes you socially uncomfortable because you’re embarrassed about your smile.

After you decide to get treatment, you’ve got another decision waiting: which treatment should you choose? There may be more than one solution for your dental issue, but remember that certain treatments might be more effective than others. Take a look at this handy table:

Consult your dentist or orthodontist to get an accurate diagnosis first. That way, you’ll know which options you have. The most important step is determining your own priorities and which treatment fits them the best.

Final Thoughts

Remember, you’re not alone in this. Tons of adults have teeth and jaw misalignments, and the good news is that there are some effective treatments available. With an understanding of your condition and some dedicated research, you can find a treatment option that best suits your life.