Orthodontics is the specialized field of dentistry focused on diagnosing, preventing, and treating dental and facial irregularities. Braces are a common treatment used to straighten teeth and correct the relationship between the upper and lower jaws for functional health and aesthetic improvement. While only an orthodontist can confirm the need for treatment, recognizing specific visual and functional signs can help you determine if a consultation is appropriate.
Visual Signs Indicating Alignment Issues
The most immediate indicators of potential alignment problems are often visible. Overcrowding occurs when there is insufficient space in the jaw for all the teeth to align properly. This causes teeth to overlap, twist, or push one another out of their ideal position, making effective oral hygiene difficult.
Noticeable gaps or spaces between teeth (diastema) are another sign that teeth are not fitting together correctly. This can occur if teeth are too small for the jawbone or due to habits like prolonged thumb sucking. Rotated teeth, where a tooth is visibly turned on its axis, also suggest a need for orthodontic intervention. Observing the general unevenness of the smile line or a mismatch in the vertical center lines of the upper and lower front teeth can also indicate an underlying alignment issue.
Symptoms Related to Bite and Jaw Function
Beyond the visible appearance of the teeth, functional symptoms indicate a misaligned bite. Difficulty or discomfort when chewing or biting is common, as poor alignment prevents the upper and lower teeth from meeting efficiently to process food. Misalignment can also cause a person to frequently bite the inside of their cheek or tongue, leading to painful sores.
A misaligned bite places uneven stress on the teeth, leading to premature or excessive wear on certain surfaces. This uneven pressure can also affect the temporomandibular joints (TMJs), causing chronic jaw pain, discomfort, or a clicking or popping sound when opening and closing the mouth. Certain speech impediments, such as lisping, can be linked to the incorrect positioning of the teeth, which affects how the tongue interacts with them to form sounds.
Understanding Specific Types of Malocclusion
The technical term for a misaligned bite is malocclusion, classified based on how the upper and lower jaws relate. An overbite (deep bite) is present when the upper front teeth overlap the lower front teeth by more than two to three millimeters vertically. A related condition is overjet, where the upper front teeth protrude horizontally far past the lower teeth, sometimes called “buck teeth.”
An underbite is the opposite, characterized by the lower jaw and teeth extending forward beyond the upper teeth. This results in the lower front teeth resting in front of the upper teeth when the mouth is closed. A crossbite occurs when some of the upper teeth sit inside the lower teeth when biting down, affecting either the front or back teeth. An open bite means that a gap remains between the upper and lower teeth, even when the back teeth are closed together.
Next Steps in Orthodontic Assessment
If you recognize any of these visual signs or functional symptoms, seek a professional evaluation. You can start with your general dentist, who may refer you to an orthodontist, or consult an orthodontist directly. The American Association of Orthodontists recommends that children have their first screening around age seven, but adults can seek treatment at any age.
The initial orthodontic assessment involves a thorough clinical examination of the teeth, jaw, and bite relationship. The specialist takes diagnostic records, including panoramic and cephalometric X-rays to visualize the teeth roots, jaw structure, and facial bone relationships. Digital scans or physical impressions of the teeth are also taken to create a precise model of your bite. These records allow the orthodontist to diagnose the specific malocclusion and develop a customized treatment plan.