Correct bite is not only the foundation of an attractive smile, but also a prerequisite for the proper functioning of the entire stomatognathic system. Harmonious alignment of the teeth and jaws affects chewing, breathing, speech, and the balance of the musculoskeletal system within the facial area.
Disturbances in these relationships, referred to as malocclusion, are among the most common orthodontic problems affecting both children and adults.
Malocclusion may have genetic, developmental, or functional causes. It often results from persistent habits such as mouth breathing, thumb sucking, or incorrect swallowing. If left untreated, malocclusion leads not only to aesthetic concerns but also to serious health issues, including excessive tooth wear, temporomandibular joint (TMJ) pain, chewing and speech difficulties, and even chronic headaches.
Our Polish clinic in London provides comprehensive healthcare in the UK. We also specialise in complex diagnosis and treatment of malocclusion, using modern orthodontic methods, digital treatment planning, and an individual approach to every patient. Our team of orthodontists has many years of clinical experience in treating both children and adults.
Modern orthodontics offers a wide range of diagnostic and therapeutic methods that make it possible to correct malocclusion effectively and restore full function of the chewing system. Thanks to advanced technologies such as 3D scanning, cephalometric analysis, and modern orthodontic braces (both fixed braces and clear aligners), durable and aesthetic treatment results can be achieved while ensuring maximum patient comfort.
In this article, we present the most common causes of malocclusion, its classification, and modern treatment methods used in our orthodontic practice.
Types of malocclusions
The most common types of malocclusions include:
- Open bite – the teeth do not meet at all
- Crossbite – the lower teeth overlap the upper teeth
- Overjet – the lower dental arch is positioned behind the upper
- Deep bite – excessive overlap of the upper teeth over the lower teeth
- Underbite – forward positioning of the lower dental arch
- Crowding – teeth too large in relation to the size of the dental arch
- Spacing – excessively large gaps between the teeth
Malocclusion represents a diverse group of disorders within the stomatognathic system, involving abnormal relationships between the maxilla and mandible as well as improper tooth alignment within the dental arch. Classification is based primarily on the direction and type of deviation from normal occlusion, as well as on Angle’s classification, which distinguishes three main skeletal relationships:
- Angle Class I – normal jaw relationship with improper positioning of individual teeth (e.g. crowding, rotations)
- Angle Class II (overjet) – the mandible is positioned posteriorly in relation to the maxilla, often resulting in protrusion of the upper teeth and the characteristic “bird-like” facial profile
- Angle Class III (underbite) – excessive forward positioning of the mandible, resulting in a reverse bite
In addition to Angle’s classification, malocclusions can also be divided according to the plane in which the abnormality occurs:
1. Sagittal (anteroposterior) malalignment
- Overjet (mandibular retrusion) – the mandible is positioned too far back; often accompanied by a receded chin
- Underbite (mandibular protrusion) – the mandible is excessively forward; lower teeth overlap the upper
- Edge-to-edge bite – incisors meet edge to edge, leading to wear and microtraum.
2. Vertical malalignment
- Open bite – a vertical gap is left between the upper and lower teeth during occlusion; may result from prolonged mouth breathing or thumb sucking
- Deep bite (overbite) – excessive vertical overlap of the upper teeth over the lower; may cause mucosal trauma and incisor wear
3. Transverse malalignment
- Crossbite – lower teeth overlap the upper on one or both sides; often associated with dental arch asymmetry
- Scissors bite – upper teeth fully overlap the lower teeth on one side; rare and difficult to treat
4. Complex malocclusion
In clinical practice, combinations of several types of malocclusions are often observed, e.g. open bite with underbite or crossbite combined with facial asymmetry. Such cases require comprehensive orthodontic diagnostics and an individual treatment plan.
Correct diagnosis of malocclusion is a key stage in treatment planning. At our clinic, the diagnostic process includes a clinical examination, cephalometric analysis, X-rays, and digital scans of the dental arches. This allows precise assessment of the nature and severity of the defect and enables effective treatment planning using fixed braces, removable braces, or clear aligners depending on the patient’s age and the advancement of the condition.
Why does malocclusion develop?
Malocclusion is a disorder with multiple causes, both genetic and environmental. This means that bite defects can be inherited or develop as a result of incorrect habits and childhood environmental factors. Understanding these causes is essential not only for treatment, but also for effective prevention.
Genetic and congenital factors
In many cases, malocclusion is inherited. Shape of the jaws, size of the teeth, and the relationship between the mandible and maxilla can all be genetically determined. A child may inherit a small mandible from one parent and large teeth from the other, resulting in crowding or abnormal arch alignment.
Congenital defects also include cleft lip and palate, which affect the development of the chewing system and require comprehensive orthodontic and surgical treatment.
Environmental and developmental factors
Malocclusion often develops during childhood as a result of environmental influences, including:
- prolonged use of a pacifier or thumb sucking
- long-term bottle feeding
- mouth breathing caused, for example, by enlarged tonsils
- improper swallowing with tongue thrusting (infantile swallowing)
These behaviours, known as parafunctions, disturb the normal development of facial muscles and tooth alignment, leading to open bite or overjet.
Early loss of baby teeth
Primary (baby) teeth maintain space for permanent teeth. Their premature loss, for example due to caries, can cause adjacent teeth to shift and result in insufficient space for permanent teeth, leading to crowding or abnormal eruption.
Functional and postural disorders
Abnormal muscle tone of the masticatory muscles, tongue, and facial muscles may disturb balance within the stomatognathic system, resulting in functional malocclusions such as open bite or crossbite. Poor body posture, such as forward head posture, may also affect mandibular position.
Systemic factors
Jaw and tooth development may also be affected by endocrine disorders, growth disturbances, or nutritional deficiencies. Deficiency of vitamin D, calcium, or protein during intensive growth may impair bone mineralisation and jaw development.
How is malocclusion treated?
Orthodontic treatment is a multi-stage process that requires an individual approach. Its goal is not only to create an aesthetic smile but also to restore proper function of the stomatognathic system - harmonious cooperation of teeth, jaws, muscles, and temporomandibular joints. Modern orthodontics combines advanced diagnostics with precise treatment planning, ensuring stable and predictable results.
Orthodontic diagnostics
Treatment begins with a thorough diagnosis, including a clinical examination, radiological analysis (panoramic X-ray, lateral cephalogram), photographic documentation, and digital scans of the dental arches. Based on this data, the orthodontist prepares an individual treatment plan tailored to the patient’s age, defect type, occlusal conditions, and aesthetic goals.
Orthodontic treatment in children
In young patients, treatment focuses on guiding proper jaw development and eliminating harmful habits. Removable braces are most commonly used, stimulating bone growth and correcting early malocclusion.
Early orthodontic intervention (especially between ages 6 and 9) can prevent the need for surgical treatment later in life. Muscle function retraining with a speech therapist or orofacial physiotherapist also plays an important role.
Orthodontic treatment in adolescents and adults
In older patients, whose skeletal growth has ended, fixed braces or clear aligners (e.g. Invisalign, Clear Correct) are mainly used.
Fixed braces allow precise three-dimensional tooth movement, while aligners are a modern, aesthetic alternative. Nearly invisible, comfortable, and easy to maintain.
In some cases, interdisciplinary cooperation is required, involving maxillofacial surgeons, periodontists, or prosthodontists, especially in skeletal defects or when full occlusal reconstruction is needed.
Orthognathic (surgical-orthodontic) treatment
In severe skeletal defects (e.g. advanced underbite or overjet due to jaw underdevelopment), orthodontic treatment alone may be insufficient. In such cases, orthognathic surgery combined with orthodontic therapy is required to restore proper facial proportions and jaw relationships.
Retention – maintaining treatment results
After active treatment, the retention phase is essential to stabilise results. Retainers (removable plates or bonded wires) are used for several months or years to prevent relapse.
At Poland Medical and Dental Clinic in London, orthodontic treatment is based on modern technologies and interdisciplinary cooperation. Each treatment plan is individually tailored to the patient’s medical and aesthetic needs.
Malocclusion treatment with Polish dentist in London
Orthodontic treatment at any age should never be a source of embarrassment. Comfort is extremally important. That is why we offer CRYSTALINE© braces:
- aesthetic, made of transparent material
- comfortable, without protruding components
- easy to insert, remove, and clean
- perfectly fitted and versatile
- enabling preview of expected treatment results before starting
We also offer metal braces, self-ligating braces, cosmetic fixed braces, and removable block appliances. Block appliances should be worn for at least 12 hours daily, typically at night and in the afternoon.
Treating malocclusion in children
At the first signs of breathing problems, object biting habits, or bruxism, a specialist consultation is recommended. Preventive visits to the dentist should take place once all baby teeth have erupted.
Orthodontic braces can usually be introduced around the age of 11. In some cases, therapy may include muscle exercises (myotherapy), always under specialist supervision. Speech therapy and physiotherapy may also be recommended.
Malocclusion prevention
The earlier treatment begins, the better. Bite formation starts in early childhood and even during pregnancy. Proper feeding position, avoiding thumb sucking and mouth breathing, and early dental check-ups play a vital preventive role.
Dental disease prevention
Regular dental check-ups are especially important during orthodontic treatment. Removable braces must be cleaned and disinfected regularly. Poor oral hygiene increases the risk of decay, decalcification, and inflammation. Orthodontic wax is recommended to prevent irritation. In case of material allergy, immediate dental and allergy consultation is required.
Malocclusion treatment with Polish Dentist in London - Summary
Malocclusion is not only an aesthetic issue but primarily a medical condition affecting chewing function, temporomandibular joints, and facial muscles. Its causes are complex, and early diagnosis combined with proper orthodontic treatment prevents serious complications and restores facial harmony and proper function.
