Malocclusion is the misalignment of teeth of upper or lower jaw or both jaws.

The literal meaning of word malocclusion is “bad bite” or “irregular bite”. Malocclusion may be present as crooked, crowded, protruding teeth, spacing between upper front teeth or generalized spacing between upper or lower teeth. It may affect a person’s appearance, speech, and/or ability to eat.

Gardiner, White and Leighton defined malocclusion as “A condition where there is a departure from the normal relation of teeth to other teeth in the same arch and/or to teeth in the opposing arch.”

It is a morphological variation and one of the most prevalent oral pathologies, next only to dental caries and periodontal diseases.

Malocclusion adversely affects the facial appearance of an individual, may cause psychological disturbances and have a negative effect on self- image. It increases the risk of caries, predispose to periodontal diseases, temporomandibular joint problems, speech defects and improper respiration. Worldwide data shows that malocclusion is more prevalent in whites than in black, more in developed countries than in developing countries, and more in urban as compared to rural populations.



Malocclusion may not have any symptoms, except unacceptable facial and dental appearance. Protruded teeth, crowding, or spacing between teeth are signs of malocclusion. Sometimes there may be difficulty in chewing, speech problems and teeth may show signs of wear and tear.
If child's teeth appear to be misaligned or if a child complains of dental or jaw pain, consult a dentist.

According to Graber malocclusion may occur due to the involvement of-
1. General Factors – Heredity, congenital defects such as cleft lip and palate, environment (prenatal and postnatal), habits like thumb sucking or finger sucking, lip or nail biting, tongue thrusting, respiratory problem like mouth breathing, trauma and accidents.
2. Local Factors includes- Abnormality in tooth shape, size and number; premature tooth loss, prolonged tooth retention, delayed eruption of permanent teeth, premature tooth loss.
Most often it occurs in children whose parents have malocclusion. When children have less or no space between their primary/baby teeth, they are at risk of having malocclusion, because the permanent teeth are larger and require more space.


It can be diagnosed during routine dental examination. If malocclusion is present, photographs, dental impressions, and x-rays are required for further assessment and treatment of the condition.


There are a number of procedures undertaken to prevent malocclusion. These procedures are covered under preventive orthodontics. Some of these procedures are as follows:

  • Parent education
  • Caries control
  • Care of primary teeth
  • Management of teeth fused to bone
  • Check for oral habits such as thumb sucking, lip/nail biting, mouth breathing, tongue thrusting etc.
  • Extraction of supernumerary teeth
  • Space maintenance  



There are a number of systems to classify malocclusion. Various classification systems are:
       • Angle’s system of classification
       • Dewey’s modification of Angle’s malocclusion
       • Simon’s classification
       • Bennet’s classification
       • Ackerman- Proffit system of classification
Angle’s classification system is the simplest and most common. Angle proposed following categories:
1. Angle’s Class I Malocclusion: 
         Patient has normal bite, normal skeletal relation and normal muscle function but may have irregularities like crowding, spacing, rotation of teeth etc.
2. Angle’s Class II Malocclusion:
         It is also known as retrognathism because upper jaw and teeth severely overlap the lower jaw and teeth.
         Two types of Class II are-
          • Class II Division I- Patient has proclined upper front teeth with abnormal muscle activity. “Lip trap” is a typical feature of this type.
          • Class II Division II- patient has lingually inclined (inwardly) central upper front teeth and labially (forwardly) tipped lateral upper front teeth.
3. Angle’s Class III Malocclusion:
    It is also known as prognathism because lower jaw is protruded (placed forwardly) as compared to upper jaw.



Misaligned teeth (Malocclusion) require orthodontic treatment. Orthodontics is a branch of dentistry which manages the growth and correction of dental and facial structures. Treatment may require removable or fixed appliances (commonly known as braces). Braces apply gentle and constant force to change tooth positions slowly and align them properly with the opposing teeth. Additional efforts and care is required to maintain oral hygiene while wearing braces. Rinsing, brushing and flossing should be done immediately after eating.

In case of crowding, extraction of one or more teeth may be required to create space and align the teeth. Space maintainers are required to maintain space for permanent tooth in place of prematurely lost tooth, until the permanent tooth is not erupted. Severe malocclusions or complicated cases may also require surgical intervention. Retainers are given to the patient to stabilize the teeth in the desired new position, after completion of the treatment. Sometimes night guards are given to prevent teeth grinding and to ease stress on jaws.




  • PUBLISHED DATE : Apr 23, 2019
  • CREATED / VALIDATED BY : Dr Rida Ziaul
  • LAST UPDATED ON : Apr 23, 2019


Write your comments

This question is for preventing automated spam submissions
The content on this page has been supervised by the Nodal Officer, Project Director and Assistant Director (Medical) of Centre for Health Informatics. Relevant references are cited on each page.