When one side of your teeth appears lower than the other, it indicates a discrepancy in the occlusal plane, the imaginary surface formed by the biting surfaces of your upper and lower teeth. This unevenness, medically termed malocclusion, can stem from various underlying factors and may affect oral function and overall health.
Common Causes of Dental Asymmetry
Several factors can contribute to one side of your teeth appearing lower than the other. These causes often originate from issues with the teeth, jaw bones, jaw joints, or surrounding muscles, and identifying the specific cause is important for effective management.
Uneven tooth wear can occur from persistent grinding (bruxism), clenching, or specific chewing patterns that put more pressure on one side. Missing teeth can lead to shifting of adjacent teeth, altering bite alignment. Additionally, improperly fitted dental restorations, such as crowns or fillings, can create high spots that interfere with a balanced bite.
Skeletal factors involve developmental or genetic influences on jaw growth. Unequal jaw growth, where the upper or lower jaw develops disproportionately, can lead to one side being longer or shorter. This can result in facial asymmetry and an uneven bite, as teeth on one side may not align correctly with their opposing counterparts.
Problems with the temporomandibular joints (TMJ), which connect your jawbone to your skull, are another common cause. Issues like disc displacement, inflammation, or arthritis within the TMJ can alter the jaw’s position and movement. This can lead to an uneven bite as the jaw attempts to find a more comfortable position.
Muscular imbalances, often linked to chronic clenching or teeth grinding (bruxism), can impact jaw posture. Sustained tension or uneven development of jaw muscles can affect how the teeth come together, contributing to an uneven bite.
Past trauma to the jaw or teeth can cause asymmetry. Injuries such as fractures or dislocations, especially during developmental years, can disrupt normal jaw growth and alignment. Even minor injuries can have long-term effects on bite balance.
Recognizing Related Symptoms
Beyond the visual observation of an uneven bite, several accompanying symptoms can indicate a misaligned occlusal plane. These signs often point to the broader impact the imbalance has on oral function and related areas.
Jaw pain or soreness is a frequent complaint, particularly on the side bearing more stress or experiencing altered movement. This discomfort can be more noticeable after waking or after periods of chewing. Clicking, popping, or grinding sounds in the jaw joint are also common indicators of TMJ involvement.
Difficulty or discomfort when chewing is common, as teeth may not meet efficiently or evenly. Individuals might favor one side for chewing, leading to uneven muscle development or increased wear on certain teeth. Headaches, earaches, or neck pain can arise from the strain placed on jaw muscles and surrounding structures.
Increased tooth sensitivity or uneven wear patterns on specific teeth can occur because certain teeth may bear excessive force during biting, leading to enamel erosion or chipping. Over time, changes in facial appearance or symmetry may become apparent, reflecting underlying skeletal or muscular imbalances.
Dental Evaluation and Diagnosis
When addressing an uneven bite, a dental professional employs a systematic approach to identify the underlying cause. The diagnostic process typically begins with a thorough assessment to gather comprehensive information.
An initial consultation involves a detailed discussion about the patient’s symptoms, medical history, and any relevant habits like teeth grinding or past injuries. This is followed by a visual inspection of the teeth, gums, and jaw movement. The dentist observes how the upper and lower teeth come together, looking for any visible discrepancies or signs of wear.
Imaging techniques are important for diagnosis. X-rays, such as panoramic X-rays, provide a broad view of the entire mouth, including teeth, jawbones, and surrounding structures. In some cases, advanced imaging like 3D cone-beam computed tomography (CBCT) scans may assess jawbone structure, detect developmental issues, or evaluate temporomandibular joint health.
Bite analysis is an important component of the evaluation. Dentists might use articulating paper to mark contact points between upper and lower teeth when biting down, identifying areas of uneven pressure or premature contact. Digital scanning or other computerized techniques can also provide a detailed analysis of how teeth fit together, offering insights into bite force distribution and alignment. Dental impressions are often taken to create study models, providing a physical representation for further analysis and treatment planning.
Addressing the Imbalance
Correcting an uneven bite involves various treatment approaches, chosen based on the identified underlying cause. The goal is to restore balanced function and alleviate associated symptoms. A personalized treatment plan is developed for each individual.
Orthodontic solutions reposition teeth and improve overall bite alignment. Braces, consisting of brackets and wires, gradually move teeth into their correct positions. Clear aligners offer a less noticeable alternative, using a series of custom-made, removable trays to achieve similar results. These methods ensure upper and lower teeth meet evenly, distributing biting forces appropriately.
Restorative dentistry addresses individual teeth that are worn down or have incorrect height. Procedures such as crowns, onlays, or fillings build up worn tooth surfaces, restoring their proper shape and height to create a more even bite. This helps re-establish proper contact between opposing teeth.
For issues related to the temporomandibular joint (TMJ), various therapies are used. Non-invasive treatments include custom-made splints or mouthguards, worn to alleviate pressure on the TMJ and promote proper jaw alignment. Physical therapy, stress management techniques, and lifestyle modifications can help reduce jaw strain and improve joint function.
Surgical interventions, known as orthognathic (jaw) surgery, address severe skeletal discrepancies where non-surgical methods are insufficient. This surgery involves repositioning the upper jaw (maxilla) or lower jaw (mandible) to achieve correct alignment and facial symmetry. It is often performed in conjunction with orthodontic treatment.
Seeking professional dental advice is an important first step. A dentist can accurately diagnose the specific cause of the uneven bite and recommend the most appropriate and personalized treatment plan to prevent further complications and improve oral health.