Your Bite: What’s the Big Deal?
A person’s bite, or the way the top and bottom teeth come together, is a crucial aspect in the way a person speaks, eats, swallows, and rests. The muscles of the face and jaw, the positioning of the teeth and the bite, the joints of the jaw, and the muscles of the head and neck, play a significant role in a person’s well-being. Such a correlation exists between them, that what may appear to be just some broken teeth, or a lopsided smile, or a unique characteristic of a person’s smile, may be a sign that a person’s muscles and/or joints may not be working properly, or that a person’s balance may be affected.
Malocclusion is when a person’s bite is not coming together the way it is meant to from an anatomical and neuromuscular perspective. Malocclusion can lead to all sorts of problems and pain.
The following pictures are examples of the more common bites. Next to each picture you will find notes detailing dental concerns and problems that may arise from such bites.
Types of Malocclusion: Different Bites & Their Consequences:
Anterior Open Bite:
Only the back teeth ( and sometimes only one tooth) touches when you bite. Because the chewing forces are not distributed among all the teeth, the teeth that do contact get overstressed which means they will wear, crack, and may require root canals and crowns in the future. Periodontal problems including bone loss around those teeth can occur. Can lead to TMD.
The lower incisors ( front teeth) are hitting the roof of the mouth instead of the incisal one third of the upper teeth. The lower jaw is significantly pushed back, predisposing patients to TMD. You will also see trauma such as mobility of the teeth, excessive bone loss, significant wear or chipping of the lower front teeth.
The lower teeth are outside of the upper teeth, which is the opposite of what it should be. You will have an abnormal chewing pattern because the lower jaw will compensate by sliding sideways in order for the teeth to engage for chewing purposes. Definitely predisposes patients to TMD and may cause facial asymmetry. It also will cause lateral stress (torque) on the teeth leading to periodontal problems and potential fracture of the teeth.
Excessive Over Jet:
Upper front teeth are protruded. Little to no contact between upper and lower front teeth. Patient will grind teeth excessively at night which over time will lead to trauma of the front teeth meaning chipped, and fractured wear of the teeth. Lower jaw is pushed back predisposing a patient to TMD. Due to excessive chewing forces on the back teeth, patient is likely to wear down or crack the back teeth.
Crowding occurs when the dental arches are not big enough for the teeth. ( Mouth is too small or in very rare cases the teeth are too big). The crooked teeth push on one another as person chews causing the crowding to get worse as the patient gets older. Patients have difficulty in cleaning and flossing teeth which leads to periodontal disease and cavities. Gums tend to be very sensitive ( inflamed, bleeding, etc.). Patients tend to clench causing abfractions and gum recession.
Patient has too much space between teeth, causing an unattractive smile and food impaction between teeth. Patients tend to develop periodontal disease. The tongue will take over the excessive space and will continue to spread teeth further apart ( flared out). Excessive tooth wear will be evident throughout the patient’s life.
Edge to Edge, with Crossbite:
Upper and lower teeth meet edge to edge, causing significant trauma due to excessive force on the teeth. Patients will often crack their teeth or require root canal treatment. There will be excessive wear and tooth sensitivity. In this picture, patient also has a crossbite which could lead to TMD.
The Perfect Bite: