Understanding Malocclusion: The Types, Causes, and Symptoms

Have you ever looked at someone’s smile and said, “I know I don’t look like that, but I can’t pinpoint why?” You could have beautiful, white teeth, but something’s off, and you can’t peg it. That one “off” thing could be a malocclusion.

Malocclusion is a common problem in people of all ages, and it’s a frequent reason for orthodontic care. Every smile is unique, though, so let’s take a closer look at the types of malocclusion, how to spot it, and what to do about it.

What Is Malocclusion?

Malocclusion is a dental alignment condition in which your upper teeth don’t align with your lower teeth. In a well-aligned smile, you should be able to draw a straight vertical line between the center of a top to the center of the tooth below it. If that isn’t happening, you have a malocclusion.

There are many different types of malocclusion, though. Let’s start with the three primary types.

Class 1 Malocclusion

Class one malocclusion is also called neutrocclusion. In this condition, your upper and lower first molars are aligned. In the front of your mouth, though, your top and bottom teeth overlap.

In other words, your teeth are aligned in the back but not in the front. That is the most common type of malocclusion.

Class 2 Malocclusion

Class two malocclusion is also called distocclusion, or more commonly, and overbite. In this condition, your full set of upper teeth are further forward than your lower teeth.

Class 3 Malocclusion

Mesiocclusion, or class three malocclusion, is better known as an underbite. If you have this type of malocclusion, your full set of lower teeth are further forward than your upper teeth.

Other Types of Malocclusion

Class one, class two, and class three are the main classifications for malocclusion in medical terms. Since their initial definition, though, orthodontists have identified other types of malocclusion.

Open Bite

In an open bite, your upper and lower teeth are vertically aligned. When you close your smile, though, your front upper and lower teeth don’t touch.

This type of malocclusion appears to happen in people who suck their thumbs longer than recommended as a child. It can also come from prolonged bottle use or pacifier use.


If you have a crossbite, it means your upper teeth fit inside your lower teeth. In other words, your full upper jaw is smaller than your lower jaw. That is one of the rarer types of malocclusion.

What Causes Malocclusion?

All the conditions above might fit under the same umbrella of malocclusion, but they all have different impacts on your daily life. They can also have a range of causes.

Natural Genetic Variances

In many people with malocclusion, the condition simply comes from the way their body forms. Because of genetics and other natural factors, their upper jaw and lower jaw might be different sizes or shapes.

Genetics can also cause you to have a small jaw but large teeth or vice versa. You might inherit a small jaw from your mother’s genetics, but large teeth from your father’s genetics and the two don’t fit together.

Birth Defects

While some people are born with teeth that are a slight variation of normal, others are born with more significant differences. Cleft lip and cleft palate are two birth defects that often lead to malocclusion.

A study found malocclusion in almost all subjects who had been born with cleft lips or cleft palates. Even if a surgeon repairs the congenital disability at an early age, the child is likely to have a malocclusion as they grow older.

Childhood Practices

We mentioned this briefly above, but certain habits in early childhood can lead to malocclusion. It tends to happen with thumb-sucking, using a bottle or pacifier for extended periods, and similar habits.

When you’re young, your body is still flexible as it forms. The extended pressure from sucking on a thumb or bottle can change the alignment of your teeth and lead to malocclusion.

Symptoms of Malocclusion

Malocclusion comes in a full array of severity levels. Some people can easily spot their malocclusion while it’s more subtle for others. With any severity level or type of malocclusion, you’re likely to see one or more of these symptoms.

Visible Misalignment

In front of a mirror, open your lips and close your teeth naturally. You should be able to see an alignment between each tooth and the tooth above or below it.

If you don’t see a vertical alignment for every tooth or your top and bottom teeth don’t meet up flatly in the front, you may have a malocclusion.

Unintentional Biting

We’ve all bitten our lip, cheek, or tongue from time to time by accident. If this happens regularly, it might mean you have a malocclusion. When the teeth don’t line up straight, they’re more likely to catch the inside of your mouth by mistake.

Irregular Speech

There are countless types of speech impediments and even more ways those speech impediments form. Certain types of speech issues like some lisps, though, can come from malocclusion.

Your teeth and tongue play a role in forming speech, and hitting the right angles or making the right movements is critical. If your teeth or jawbone are misaligned, you may not be able to form all the same sounds as someone without malocclusion.

Repeated Discomfort

Your teeth are supposed to line up so you can chew food with ease. When they don’t line up, it can put extra pressure on your teeth and jaw.

If you often have discomfort while chewing, and it isn’t coming from other dental problems like tooth decay, you may have a malocclusion. The same is true if you often have a sore jaw.

What to Do if You Suspect Malocclusion

The good news with malocclusion is that it’s typically easy to treat with orthodontic care. While the guide above can help you learn more about your alignment, an orthodontist must examine you to offer a clear diagnosis and treatment plan.

To start that process, call our orthodontic office today.