Crooked Teeth: Symptoms, Treatment, Causes

Crooked teeth are defined as overcrowded, twisted, or overlapping teeth. People of all ages suffer from such quite common conditions. Crooked teeth are readily apparent when teeth are misaligned. Asymmetrical facial features, speech difficulties such as a lisp, and difficulties or distress while chewing are additional signs that suggest such a condition. These symptoms underscore the functional and aesthetic issues associated with misaligned teeth.

Crooked teeth and misaligned bites impede effective chewing, making it more difficult to maintain oral hygiene and increasing the risk of tooth decay, cavities, and gingivitis. It strains the jaws, muscles, and teeth, increasing the chances of tooth fracture and impacting self-esteem and confidence. Dentists examine signs such as aberrant tooth alignment, abnormal facial appearance, difficulty or discomfort during chewing or biting, and speech difficulties, such as a lisp, to determine whether teeth are crooked. The dentist refers the patient to an orthodontist, a specialist in diagnosing and treating misaligned mandible and crooked teeth if these signs are present.

Jaw size, behavioural habits, poor jaw alignment, genetics, inadequate dental care, poor nutrition, injury, and early baby tooth loss cause crooked teeth. A softer diet has shrunk the jaw, causing crowded and crooked teeth. Pacifier use, thumb sucking, tongue thrusting, and mouth breathing misalign teeth. Underbite, overbite, crossbite, overcrowding, and open bite result from malocclusion, which occurs when the upper and lower teeth do not fit properly. Misaligned jaws, additional teeth, and abnormally large teeth are genetic. Poor dental hygiene causes decay and tooth loss, leaving gaps for neighbouring teeth. Poor diet causes decay and stunts dental growth. Early loss of baby teeth and facial trauma potentially misalign teeth. See an orthodontist for more information.

Modern orthodontics offers numerous effective treatment options for correcting crooked teeth. Removable braces are ideal for simple orthodontic problems and are used in children. Fixed metal braces, which use brackets, bands, and flexible wire, have been significantly improved over the years, becoming more comfortable with smaller brackets and less metal. Ceramic braces offer a more discreet alternative, utilising transparent or tooth-coloured archwires to be less noticeable. Invisible lingual braces are fitted on the inner surfaces of the teeth, making them invisible when smiling for individuals seeking an almost invisible solution. These are popular among adults seeking discreet treatment. Teeth contouring, bonding, veneers, and crowns are additional ways of treating crooked teeth.

Crooked teeth affect scoliosis and other spinal disorders, according to new research. Induced malocclusion in rats affects spinal alignment, according to CBCT research. The Journal of Scoliosis found a greater rate of unilateral Angle Class II malocclusions in scoliosis patients. Children with such a malocclusion generally have a forward head posture, which increases spinal strain. Studies have indicated that lateral crossbites and midline abnormalities in children increase scoliosis risk, suggesting early orthodontic treatments are beneficial. Research shows that crooked teeth are more prone to plaque buildup, increasing cavities and gum disease risk. Misaligned teeth are likely to cause fractured teeth, teeth grinding, and TMJ issues. Orthodontics is essential for cosmetic dental and spinal health, highlighting the need for interdisciplinary care.

What are the Types of Crooked Teeth?

The types of crooked teeth are listed below.

Crossbite: A crossbite is a condition in which the upper teeth bite into the lower teeth. Crossbite occurs due to insufficient space between teeth, an excessively lengthy upper jaw, or an extremely short lower jaw.

Overbite: An overbite is characterised by the upper teeth surpassing the lower teeth (biting surface of lower teeth). It results from a short mandible, which causes the lower jaw to be elevated above the upper jaw. A minor overbite jaw is corrected through various methods; however, braces are employed to lengthen the jaw and restore the teeth to their natural position when the overbite is pronounced.

Underbite: An underbite is a condition in which the lower teeth bite into the upper teeth. The condition is more prevalent than an overbite because the lower mandible is shorter than the upper jaw, resulting in the lower teeth biting into the upper teeth. The lower jaw's side teeth are positioned within the upper jaw's side teeth, causing a crossed bite.

Openbite: An open bite occurs when the upper teeth are broader than the lower teeth and do not contact. It makes chewing food properly difficult, resulting in tooth misalignment and wear. It is because the jaws do not close appropriately.

Overcrowding: A condition in which the front teeth are congested is overcrowding. It is most frequently observed in young infants and results from genetic factors such as heredity and ethnicity. Genetic factors, in which one or both parents exhibit a congested smile, are the most prevalent cause. It is more common in individuals who have recessive genetic conditions.

Overjet Teeth: The upper teeth protrude beyond the lower teeth during the process. Excessive pressure on the teeth, growth disturbance, or improper brace positioning result in overjet. The upper and lower jawbones become crowded because braces are affixed too closely to the teeth. The overjet results in a crossbite, an overbite of the adjacent tooth, and facial asymmetry.

Spacing: Spacing is the term used to describe the condition in which the teeth are evenly spaced and do not overlap. It is due to various factors, including tooth decay, an overbite (a mandible that is too short), or an insufficient or excessive amount of space for the growth of new teeth. Spacing is most frequently observed in children but manifests in adults, too.

Missing Tooth: One or more teeth are missing in certain instances. A missing tooth results from an injury, dental disease (caused by trauma or cavities), or health issues. Scheduling routine dental examinations with a dentist is crucial to avoid unnecessary complications.

Impacted Tooth: An impacted tooth is a tooth that is unable to emerge from the gum due to being forced inward. Swelling, infection, and discomfort result from such. An impacted tooth is the consequence of a gingival infection and necessitates treatment by a dentist.

Diastema: Diastema is a space between two teeth, typically the front two on the top and bottom. It is the result of heredity or the timing of tooth emergence. There is a factor in diastema that is distinct from spacing: the occurrence of one tooth growing in front of another. The permanent tooth emerge and fill the gap when there is an opening between the teeth.

What are the Symptoms of Crooked Teeth?

The symptoms of crooked teeth are listed below.

Jaw pain and headaches: Malocclusion, or crooked teeth, results in jaw pain and headaches, placing an additional burden on the jaw muscles and temporomandibular joints (TMJ). The jaw muscles are compelled to exert more effort to chew and speak when teeth are not symmetrically lined up, resulting in muscle fatigue and discomfort. The heightened tension in the jaw radiates to the skull, contributing to headaches. Improper bite patterns result from misaligned molars, exacerbating muscle strain and discomfort. Orthodontic treatments ameliorate the signs connected with these alignment issues by enhancing the alignment of teeth and relieving the strain on the jaw muscles and joints.?

Plaque buildup: The inability to effectively clean misaligned areas is a frequent issue associated with crooked teeth, which results in plaque accumulation. Food particles and pathogens accumulate in hard-to-reach spaces when teeth are not properly aligned. Plaque, a viscous film of bacteria, is formed in these areas due to the difficulty of cleaning them with regular brushing and flossing. The risk of cavities, gum disease, and poor breath is elevated due to the potential for plaque to harden into tartar over time. It exacerbates the issue by making it more challenging to maintain proper dental hygiene. Orthodontic treatments that align teeth assist in the reduction of plaque accumulation by enhancing the effectiveness and comprehensiveness of oral hygiene practices.?

Tooth decay and gum disease: Poor dental hygiene makes crooked teeth prone to decay and gum disease. Misaligned teeth generate tight, overlapping gaps that are hard to brush and floss. Producing acids that destroy tooth enamel, plaque, and a sticky coating of bacteria cause cavities. Plaque along the gum line causes gingivitis, an early gum disease with inflammation and bleeding. Gingivitis leads to periodontitis, which causes tooth loss if addressed. Orthodontic treatment enhances oral hygiene, reduces plaque, and lowers tooth decay and gum disease risk.?

An overbite or underbite: Crooked teeth cause an overbite or underbite, which changes how the upper and lower teeth connect. The upper front teeth overlap the lower front teeth in an overbite, while the lower teeth protrude in an underbite. Poor tooth and jaw alignment cause uneven tooth wear, jaw pain, and difficulties biting and chewing. Overbites and underbites cause speech problems and TMJ disorders, which cause chronic pain and discomfort. Braces or clear aligners address these misalignments, improving bite and oral function.?

What are the Causes of Crooked Teeth?

The causes of crooked teeth are listed below.

Genetics and hereditary factors: A person's likelihood of developing congested or crooked teeth increases if their parents have such conditions. An overbite or underbite is sometimes inherited from parents.

Misaligned jaw: Upper teeth must fit slightly above lower teeth, with upper molar tips fitting into lower molar grooves. Malocclusion occurs when such an alignment fails. Overbite and underbite are common faults. Overbite causes upper front teeth to protrude more than lower front teeth. Underbite causes lower front teeth to protrude more than higher front teeth. Malocclusions result from poor myofunctional behaviours.

Bad myofunctional tendencies: Myofunctional habits are repetitive behaviours that affect the mandible's and face's muscles or functions. These behaviours encompass thumb sucking, mouth breathing, tongue thrusting, and the use of a pacifier or formula. These behaviours influence dental alignment and facial development, resulting in misaligned teeth, altered bite patterns, and changes in the structure and function of the jaw and face. Address these behaviours early, frequently through behavioural interventions or myofunctional therapy, to prevent long-term dental and orthodontic issues.?

Jaw size: The soft, processed food that is typical of the modern diet that many individuals consume necessitates less digestion than the foods that the early ancestors consumed. The modification has reduced the size of human’s collective mandible. Scientists suspect humans evolved shorter mandibles, resulting in crowded, crooked, and misaligned teeth.

Facial injury: A blow to the face or jaw that tosses teeth out of their proper position, resulting in single or multiple crooked teeth.

Poor nutrition: Poor nutrition, particularly in youngsters, causes tooth decay and poor dental development, contributing to crooked teeth.

Poor dental care: Neglecting to have the teeth examined by a dentist at least once a year results in neglecting issues, including cavities and periodontal disease. Crooked teeth and other dental health issues result from such.

What are the Treatments of Crooked Teeth?

The treatments of crooked teeth are listed below.

Crowns: Achieving a confident smile is feasible for teeth that are significantly decayed or broken. Dental crowns are affixed to the damaged or fractured teeth to restore their appearance and functionality after any decay has been addressed. These crowns function identically to natural teeth and appear as if they were never worn. In certain instances, a camera-ready smile is achieved by combining veneers and crowns. Crowns last up to 30 years with appropriate oral hygiene and proper care, although they are not intended to endure indefinitely.

Veneers: Veneers are a more expeditious alternative to braces. They are composed of a thin coating of porcelain that is applied to the natural teeth to conceal any imperfections. Veneers conceal teeth that are misshapen or severely discolored and cannot be whitened in addition to straightening them. The outcomes are remarkable, frequently resulting in a "Hollywood smile" in a few appointments. However, the disadvantage of veneers is that they necessitate the removal of a portion of the tooth surface to achieve the desired outcome. Braces are suggested as a less invasive treatment option if the teeth are healthy but merely crooked.

Braces: Orthodontic treatment is the optimal long-term solution for teeth that are crooked or congested despite being otherwise healthy. Teeth are gradually relocated through removable aligners or fixed braces to expose a straight smile. Braces are not a fast fix; the process requires months or even years. The outcomes are worthwhile, and the new smile endure for an eternity with the consistent use of retainers. Modern orthodontics is constantly evolving, providing patients of all ages with more efficient, comfortable, and discreet treatment options.

Teeth bonding: Dental bonding is a cosmetic treatment that is minimally invasive and straightforward, similar to teeth contouring. It is used to achieve straighter teeth. Experienced clinicians meticulously construct and reshape the teeth to achieve a more symmetrical appearance by employing tooth-coloured composite. The composite material produces an indistinguishable natural appearance from natural teeth. The treatment is reversible and requires less than an hour to complete.

Teeth contouring: Teeth contouring is an appropriate solution for teeth that are only marginally crowded. The uncomplicated and simple treatment meticulously reshapes the teeth to achieve a neater and straighter appearance. The procedure is entirely painless and does not result in tooth injury. The treatment yields a smile substantially enhanced in less than an hour.

Teeth whitening: Teeth whitening seems to be an unconventional inclusion in treating crooked teeth; however, it substantially influences the overall appearance of a smile. Teeth whitening produces a discernible improvement by increasing the color of the teeth by several hues and guaranteeing a consistent hue, although it does not involve tooth movement. The modification has the potential to significantly enhance the appearance of a smile, resulting in a more uniform and healthier appearance.

Can Crooked Teeth Be Treated At Home?

No, crooked teeth cannot be treated at home. Professional orthodontic intervention is required to ensure safe and successful realignment. Orthodontic treatments, such as fixed braces or removable aligners, are designed to gradually and precisely move teeth into their proper positions using controlled pressure. These treatments are tailored to the patient’s needs and monitored by orthodontists to prevent complications.

Attempts to straighten teeth at home using DIY methods, such as borrowed retainers, rubber bands, or other homemade devices, lead to severe dental problems. These unsupervised methods cause damage to the teeth, roots, and gums, leading to tooth decay, cracked teeth, weakened enamel, oral infections, and even tooth loss. The roots and ligaments that secure teeth are sensitive to improper force, and DIY methods exert excessive strain, potentially causing irreversible damage.

The only proven and safe alternatives to traditional braces are professionally administered treatments, such as jaw surgery for severe cases. Other dental treatments, such as palatal expanders, Herbst appliances, and cosmetic procedures like veneers, complement orthodontic care but must be carried out under professional supervision. Correcting crooked teeth must consult an orthodontist to determine the most suitable treatment.

What are the Researches about Crooked Teeth?

The research about crooked teeth highlights a significant connection between dental alignment and spinal health, indicating that crooked teeth influence scoliosis and other spinal issues. Animal studies and human clinical research are shedding light on such a relationship. For instance, studies on rats have demonstrated that induced malocclusion (bite misalignment) leads to shifts in vertebral alignment over time, as seen through the Cone Beam Computed Tomography (CBCT) analysis. These findings suggest that abnormalities in dental bites impact spinal structure, at least in animal models. Human studies support the connection. The Journal of Scoliosis, for example, has reported a higher occurrence of unilateral Angle Class II malocclusions in individuals with scoliosis. The malocclusion, where the lower jaw is set back, causing the upper teeth to flare forward, is prevalent in children and is linked to forward head posture, exacerbating spinal strain.

Treating a Class II bite by expanding the maxilla (upper jaw) and encouraging the forward positioning of the mandible (lower jaw) to support the temporomandibular joint (TMJ) and potentially ease the spinal strain. Studies have shown that lateral crossbites and deviations in the midline in children increase the risk of scoliosis, suggesting that early orthodontic interventions correct dental irregularities and reduce the likelihood of developing spinal conditions.

The growing body of evidence underscores the importance of an interdisciplinary approach to healthcare, where dentists, chiropractors, osteopaths, and physiotherapists work together to recognise and address health issues affecting dental and spinal well-being. TMJ issues, or noticing a link between dental health and posture, further exploring the connection with dental professionals provide insights and treatments that improve oral and spinal health for individuals experiencing headaches. Research is needed to understand the extent of the connection, but current research shows that dental health plays an integral role in well-being, promoting an approach to healthcare that reflects how the body is interconnected.

Research on crooked teeth has revealed several significant dental risks associated with malocclusion. Crooked teeth, whether crowded or with small gaps, tend to accumulate more dental plaque due to the difficulty in thoroughly cleaning the misaligned areas. The plaque buildup, which contains bacteria, food debris, and exfoliated tissue cells, increases the risk for cavities and gum disease. Studies have shown that crowded teeth harbour more dangerous strains of bacteria, precisely the kind that cause periodontal disease.

The improper alignment of teeth affects how the upper and lower jaws meet, known as occlusion. Poor occlusion leads to cracked teeth, as the misaligned teeth absorb forces at improper angles, making them more prone to damage. Malocclusion increases the risk of teeth grinding and temporomandibular joint (TMJ) problems. Misaligned teeth strain the jaw joints, leading to wear and tear similar to arthritis. Orthodontic treatment is crucial in aligning teeth correctly to reduce these risks, ensuring that biting forces are distributed properly, extending the lifespan of the teeth, and preventing further complications. These findings underscore the importance of addressing orthodontic issues for cosmetic reasons, maintaining dental health, and preventing more severe dental problems.

What are the Differences between Crooked Teeth and Hyperdontia?

The differences between crooked teeth and hyperdontia lie in their causes, symptoms, and treatment options. However, crooked teeth and hyperdontia share certain similarities in their impact on oral health. Malocclusion (crooked teeth) is the consequence of genetics, facial trauma, jaw misalignment, thumb sucking, and tongue thrusting. These causes result in the growth of teeth in misaligned positions, which lead to various challenges, including communication difficulties, an increased risk of gum disease, and a decrease in self-esteem due to the aesthetic impact. Hyperdontia is defined by supernumerary (extra) teeth resulting from genetic factors, an overactive dental lamina, or specific health conditions such as Gardner syndrome and cleidocranial dysplasia. Hyperdontia results in malocclusion, overcrowding, and tooth impaction, comparable to the complications associated with misaligned teeth.

Overcrowding and malocclusion cause similar symptoms, such as aesthetic concerns that affect self-esteem, gum disease, tooth decay, and difficulty chewing. The primary distinction between the two is that crooked teeth are frequently the result of external behaviours or a genetic predisposition to jaw size and shape. Hyperdontia, on the other hand, is primarily caused by genetic factors that result in the development of extra teeth. Braces, Invisalign, retainers, and occasionally surgery to rectify jaw alignment are typically used to treat crooked teeth. Hyperdontia necessitates the extraction of additional teeth to prevent congestion and guarantee the proper alignment of the remaining teeth.

Crooked teeth and Hyperdontia, despite their distinctions, require early detection and appropriate dental care to prevent long-term complications and preserve oral health. Regular dental check-ups are essential for diagnosing and managing hyperdontia and crooked teeth effectively. They ensure that prospective issues are promptly addressed to minimise their impact on dental health.

Dentist Dr. Dt. Erdem CETIN

He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).

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