Misaligned teeth in children & teenagers

Misalignments of the teeth and jaw are widespread among children and teenagers and can occur on their own or in combination. Many of these misalignments not only affect appearance but also lead to functional problems and health impairments in the long term. Early detection and treatment are therefore crucial to avoid later complications or even surgery.

At the Eltz Institut, we have a specialised team dedicated to the treatment of children and teenagers. By using state-of-the-art technology and regular check-ups, we can detect and treat misalignments early, before they lead to more serious problems.

Overjet

Overjet is the most common form of misalignment. The lower jaw sits too far back, creating a gap between the upper and lower incisors.

Possible consequences:

• Deep bite: When biting together, the upper incisors overlap the lower teeth. This can lead to injuries to the gums. The lower incisors can grow into the palate and  injure the lining of the palate.

• Injury: The risk of injury to the incisors (for example during sport) is high. The lip no longer lies protectively over the teeth, and the lower teeth cannot provide additional support.

• Functional problems: There may be problems with biting off food, chewing or speech.

• Teeth wear down: Because the teeth do not mesh together exactly, the teeth wear down considerably. As a result, severely worn tooth crowns can be seen even in young adults.

• Jaw joint (TMJ) problems: An overjet forces the lower jaw to bite further forward. This can overload the jaw joint. As a result, there may be clicking in the jaw joint or considerable pain.

Underbite

With an underbite, the lower jaw bites too far in front of the upper jaw. The incisors sometimes meet edge to edge or even bite the wrong way round, one behind the other, in what is known as a crossbite.

Possible consequences:

• Jaw joint (TMJ) problems occur: The jaw joint can be overloaded. This leads to clicking, or to restricted opening or locking of the jaw with considerable pain.

• Teeth wear down: Because the teeth do not mesh together properly, the teeth wear down excessively. Severely worn tooth crowns are not unusual in young adults.

Cover bite

A special type of Class II malocclusion is the cover bite (Angle Class II, Div. 2). Typically, in a cover bite, some of the upper front teeth tilt backwards and the others tilt forwards.

Possible consequences:

• Deep bite: The lower incisors can grow into the palate and  injure the lining of the palate.

• Injury: The risk of injury to the protruding incisors is high, for example during sport,  because the lip no longer lies protectively over the teeth and the lower teeth cannot provide additional support.

• Crowding: The dental arches collapse because they are not supported by one another.

• Teeth wear down: Because the teeth do not mesh together exactly, the teeth wear down more heavily. As a result, severely worn tooth crowns can be seen even in young adults.

• Jaw joint (TMJ) problems: In some cases, the backward-tilted front teeth cause a forced bite. The reason is that  the lower jaw is guided further back when biting together. This overloads the jaw joint and may lead to clicking, or to restricted opening or locking of the jaw with considerable pain.

Crossbite

In a lateral crossbite, the lower back teeth bite over the outside of the upper back teeth. A crossbite can occur on one side or on both sides.

Possible consequences:

• Lopsided face: Over the years, a one-sided crossbite – if left untreated – causes the lower jaw to shift towards the side of the crossbite. The midlines of the dental arches no longer line up.

• Jaw joint (TMJ) problems: A one-sided crossbite forces the lower jaw to bite in a particular direction. In some cases, this overloads the jaw joint. As a result, clicking or considerable pain may occur.

• Wear of the teeth: Because the teeth do not mesh together exactly, the teeth wear down considerably. As a result, severely worn tooth crowns can be seen even in young adults.

Crowding

With crowding, the front teeth overlap one another. In some cases, the misalignment is so pronounced that teeth stand almost one behind the other.

Possible consequences:

• Pain: The teeth are very sensitive to pain.

• Receding gums: As the teeth migrate out of the bone, very pronounced gum recession develops on individual teeth over the years.

• Excessive tooth decay: Some teeth hardly get cleaned. As a result, tooth decay or at least gum inflammation very often develops. Discolouration of the teeth is not uncommon.

• Wear of the teeth: Because the front teeth do not mesh together exactly, the teeth wear down more heavily. As a result, severely worn tooth crowns can be seen even in young adults. This impairs the appearance of the teeth.

Gaps between the teeth

Gaps between the teeth often considerably affect appearance.

Possible consequences:

• Receding gums: As the teeth migrate out of the bone, very pronounced gum recession develops on individual teeth over the years.

• Gaps form in the back teeth: If they are not treated, these gaps can lead to considerable over-eruption of the opposing tooth in the upper or lower jaw. This would then have a negative effect on the  bite.

• Teeth drift: The teeth can drift because they are not supported by one another.

• Functional problems: There may be problems with biting off food.

Open bite

With an open bite, the front teeth of the upper and lower jaw do not touch each other even when biting together. In extreme forms, only the very back molars touch when biting.

Possible consequences:

• Inability to bite off food: These patients can no longer bite through something like a thin slice of cheese. Chewing function is severely impaired.

• Jaw joint (TMJ) problems: In some cases, the jaw joint can become overloaded. As a result, clicking or considerable pain may occur.

• Teeth wear down: The overloading of the back teeth increases the loss of tooth enamel, which often makes costly dental restorations necessary later on.

• Lower jaw looks longer: Purely visually, the face can appear long.

Protrusion

The forward “tipping out” of the front teeth is called protrusion (proclined front teeth). To bring the front teeth back into the jawbone, either the back teeth have to be moved backwards or even healthy teeth have to be extracted. In adulthood, this tooth movement often begins suddenly with an inflammation of the gums accompanied by bone loss (periodontitis).

Possible consequences:

• Gaps: In some cases, gaps form between the teeth.

• Receding gums: As the teeth migrate out of the bone, very pronounced gum recession develops over the years.