Malocclusion: Misaligned teeth

28 May, 2017 - 00:05 0 Views

The Sunday News

GREETINGS health care column readers. Today’s article is about malocclusion, the bad habits that infants, toddlers and children have and their negative effect on a child’s teeth and healthy development.

Occlusion is defined as the alignment of teeth and the way that the upper and lower teeth fit together. The upper teeth should fit slightly over the lower teeth. The points of the molars (posterior teeth) 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.A good occlusion contributes also to a beautiful smile, a symmetrical and proportional face.


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 may also be reasons for malocclusion.

Other causes include:

Childhood habits such as thumb sucking, tongue thrusting, pacifier use beyond age three, and prolonged use of a bottle.

Thumb sucking is a natural reflex for children. Sucking on thumbs, fingers, pacifiers or other objects may make babies feel secure and happy and help them learn about their world. Young children may also suck to soothe themselves and help them fall asleep.

n Extra teeth, prematurely lost or extracted teeth, impacted teeth: tooth that gets blocked as it is pushing through the gum into your mouth (erupting), 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.

How Childhood Habits Can Affect Your Child’s Teeth?

After permanent teeth come in which is usually at the age of six, thumb-sucking and tongue thrusting may cause problems with the proper growth of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth.

Pacifiers can affect the teeth the same ways as sucking fingers and thumbs, but it is often an easier habit to break.

The intensity of the sucking is a factor that determines whether or not dental problems may result.

If children rest their thumbs passively in their mouths, they are less likely to have difficulty than those who vigorously suck their thumbs. Some aggressive thumb-suckers may develop problems with their milk (primary) teeth.

Thumb and finger-sucking and pacifier use for more than 4 to 6 hours in 24 hours can eventually:

Push the upper front teeth (incisors) outward and the lower incisors inward (overjet).

Prevent the permanent incisors from coming in (erupting) completely (open bite).

Cause the top molars to bite inside the lower molars (cross bite).

The sooner a child stops sucking on a finger, thumb, or pacifier, the better for incoming permanent teeth. Pediatric dentists recommend that you take your child to see a dentist if your child is 4 years old and still has a sucking habit. If this habit lasts until age five or six, your child’s permanent incisors probably won’t come in straight.

Symptoms of Malocclusion

Abnormal alignment of teeth

Abnormal appearance of the face

Difficulty or discomfort when biting or chewing

Speech difficulties (rare)

Mouth breathing (breathing through the mouth without closing the lips)


If the cause of malocclusion is a childhood habit, parents should try to eliminate the habit as soon as possible.There is no one way to stop a child from thumb sucking, each child and situation is different, however, here are some helpful guidelines as to how best to approach the problem.

Some children are not ready or able to stop their sucking habit, despite their dentists’ or parents’ decision that they must.

Some parents and professionals believe that when a child won’t co-operate, the treatment won’t be effective. It could even be traumatic and may prolong the habit.

Others believe that it’s sometimes necessary to try to stop the habit without the child’s co-operation.

Consider these tips when helping your child quit thumb-sucking or related habits:

Pick a low-stress period of time. Avoid a time of change or challenge, such as a move, divorce, the start of the school year, or even a new sports activity.

Enlist your child’s dentist for providing some education about the effects of thumbsucking.

Help your child put away any attachment objects that may trigger the sucking habit, such as a baby blanket or toy.

With your child, develop a reminder for not sucking the thumb, such as putting a mitten, a sock, an adhesive bandage, or a bitter-tasting substance on the thumb, especially at night. A bulky elastic bandage, loosely wrapped around the mid-arm, can make it difficult for the hand to reach the mouth while your child sleeps.

Use positive reinforcement. Compliment your child for the smallest of gains as well as the big successes.

Develop a reward system, such as putting a star on the calendar for each successful day. After an agreed-upon number of days, have a celebration for your child.

After the childhood habit is no longer a factor, treatment options are:

Braces or other appliances:

Removal of one or more teeth: if overcrowding is part of the problem.

Repair of rough or irregular teeth: Teeth may be adjusted down. Misshapen restorations and dental appliances should be repaired.

Surgery: Surgical reshaping to lengthen or shorten the jaw is needed in rare cases.

Remember a beautiful smile is beauty within.

Kimberley Eve Nyathi

Final year student



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