Occlusal cant refers to a noticeable tilt or slant in the occlusal plane, the imaginary line formed by the biting surfaces of your teeth. This common dental and facial asymmetry can impact facial harmony and oral function.
Understanding Occlusal Cant
The occlusal plane is the line where your upper and lower teeth meet when you bite down. A level plane contributes to balanced facial features and proper dental function. An occlusal cant indicates this line is tilted, meaning one side of your teeth appears higher or lower than the other. This tilt can be observed in the front, affecting the smile line or gum line.
This tilting can affect the upper jaw (maxilla), the lower jaw (mandible), or both, leading to noticeable asymmetry in the smile and overall facial appearance.
Identifying Occlusal Cant
Recognizing occlusal cant often involves observing specific visual signs. An uneven smile line is a prominent indicator, where one side of the mouth appears higher or lower when smiling. This can also manifest as a tilted jaw or an unlevel gum line, where the gums above the teeth appear to follow an angled path. Asymmetry of the lips or chin might also suggest an underlying occlusal cant.
Dental professionals use various methods for identification, including clinical assessment, frontal photographs, and X-rays or 3D imaging. These tools help precisely measure the degree of the cant and its relationship to the overall facial structure. While primarily a visual concern, an occlusal cant might also be linked to subtle functional issues, which can sometimes be detected through a thorough dental examination.
Common Causes of Occlusal Cant
Occlusal cant can stem from various factors, ranging from developmental issues to acquired conditions. Uneven growth of the jaws, known as skeletal asymmetry, is a frequent cause, where one side of the upper or lower jaw develops differently from the other. Genetic predispositions can also play a role, influencing the overall growth pattern of the craniofacial structures.
Facial trauma or injuries to the jaw can disrupt normal growth or shift existing structures, leading to a cant. Dental factors also contribute, including uneven tooth wear, missing teeth that cause surrounding teeth to shift, or poorly fitted dental restorations like crowns or bridges. Consistent unilateral chewing habits may also lead to an uneven distribution of forces, contributing to an occlusal cant.
Impact of Occlusal Cant
The consequences of an occlusal cant extend beyond its visual appearance. Aesthetically, it can affect facial symmetry and smile attractiveness. This can lead to self-consciousness and impact an individual’s confidence.
Beyond aesthetics, occlusal cant can lead to functional issues. Individuals might experience difficulty chewing food evenly, as the misaligned bite can prevent proper tooth contact. Speech impediments can also arise if the teeth and jaw are not positioned correctly for articulation. The uneven distribution of bite forces can strain the temporomandibular joints (TMJ), potentially leading to temporomandibular joint disorders (TMD), characterized by jaw pain, headaches, and clicking or popping sounds in the jaw.
Correcting Occlusal Cant
Correcting an occlusal cant involves various treatment approaches, tailored to the underlying cause and severity. For cants primarily due to tooth positioning, orthodontic treatment is a common non-surgical option. This involves using braces or clear aligners to gradually reposition teeth, leveling the occlusal plane. Advanced orthodontic techniques can achieve precise tooth movements, sometimes avoiding the need for surgery in milder cases of facial asymmetry.
When the occlusal cant is caused by skeletal discrepancies, orthognathic surgery, also known as jaw surgery, may be recommended. This involves surgically repositioning the jawbones to achieve a balanced and level occlusal plane. Prosthetic solutions, such as veneers or crowns, can also be used to camouflage minor cants by altering the visual length and alignment of teeth, offering a less invasive option for aesthetic improvement. The choice of treatment ultimately depends on a comprehensive diagnosis and discussion with a dental professional.