Misaligned teeth: An overview of causes, types, consequences and treatment options

What types of misaligned teeth are there and what are their consequences?

Misaligned teeth can vary greatly in their severity. Only a single tooth or the entire dental arch may be affected. Several different malocclusions can occur simultaneously in one jaw. Some typical malocclusions are described below:

• Tooth rotation, tooth tilting: Tooth rotation and tilting are probably the classics among tooth misalignments. Tooth rotation is a rotation of the tooth around its own axis. In the case of tilting, the axial inclination of a tooth is incorrect. Tooth rotation and tilting often occur in combination. They are often associated with crowded teeth. Crooked, clearly tilted or rotated incisors are perceived as unaesthetic.
• Crowding: Crowding of the teeth is observed when the teeth do not have enough space in the jaw . A distinction is made between primary, hereditary crowding, where there was not enough space to begin with, and secondary, acquired crowding, where the space has been lost due to tooth migration. Crowded teeth are more difficult to clean.
• Buccal/lingual position: A buccal position is when a tooth is positioned too far outwards in relation to the dental arch. Conversely, in a lingual position, the tooth is positioned too far inwards. This can result in a crossbite.
• Crossbite: Teeth from both jaws are always involved in a crossbite, although the cause may lie in only one of the two jaws. Normally, all the teeth in the upper jaw are further out than the teeth in the lower jaw. A crossbite occurs when this relationship is reversed. A distinction is made between frontal crossbite, which affects the incisors, lateral crossbite, which affects the posterior teeth, and circular crossbite, which affects all teeth. A crossbite can disrupt clenching to such an extent that the lower jaw can no longer assume its correct position. As a result, it seeks a new, so-called forced bite position, which can lead to functional problems in the form of craniomandibular dysfunction.
• Nonocclusion: Similar to crossbite, nonocclusion is a disordered bite between the upper and lower teeth. This time, however, the teeth do not bite incorrectly into each other, but completely past each other. The consequences are comparable to those of a crossbite. The lack of support can also cause the teeth to continue to grow (elongate) and ultimately disrupt the movement of the lower jaw.
• Protrusion: Incisors that are too far forward are referred to as protrusion. A protrusion of the maxillary incisors can often be observed with an incorrect swallowing pattern or sucking habits. This results in an enlarged overbite. The exposed position of protruding teeth is associated with a significantly increased risk of dental injuries in the event of accidents. If the incisors are protruding in both jaws, this can result in difficult or even impossible lip closure.
• Retrusion: Retrusion is the opposite of protrusion. In this case, the incisors are positioned too far inwards. A crowding often occurs in combination with retruded incisors.
• Supraposition: Teeth in supraposition have grown too far out of the jaw. This makes them very prominent. Under certain circumstances, they can interfere with free movement of the lower jaw. During movements with tooth contact, they show increased signs of wear (abrasion).
• Infraposition: Teeth in infraposition are not fully erupted. This means that there is no tooth contact with the teeth in the opposing jaw (open bite). The chewing and biting function may be impaired as a result.