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  Posted by: Dental Design      12th February 2024

Malocclusion can lead to a variety of oral health problems

A schoolboy in Henley has recently started a campaign to persuade technology behemoth Apple to change its ‘offensive’ nerd emoji. The emoji is a smiley face with protruding teeth and thick-rimmed glasses.[i] The 10-year-old has redesigned it – removing said teeth – and has renamed it the ‘genius emoji’.

Malocclusion is very common, too common in fact. The World Health Organisation considers it one of the most important oral health problems, after caries and periodontal disease. Its prevalence is estimated to be between 39% and 93% in children and adolescents.[ii] It can occur in three different spatial planes: sagittal, transverse and vertical.

Oral health problems associated with malocclusion can range from mild to severe, affecting not only the appearance of a person’s smile but also their overall oral health. It can occur due to a variety of factors including genetics, oral habits and certain medical conditions (such as cleidocranial dysplasia). Children who suck their thumbs, for example, tend to develop an anterior open bite and posterior cross-bite due to the lack of palatal development. Posterior teeth may also extrude, caused by the lack of occlusal contract due to the interposition of the thumb.ii

Risk of tooth decay

One of the most common problems associated with the condition is difficulty in maintaining proper oral hygiene.[iii] Malocclusion can cause teeth to overlap, creating tight spaces and crevices that are difficult to clean properly. These hard-to-reach areas become havens for plaque and bacteria, increasing the risk of tooth decay and gum disease. Additionally, misaligned teeth can also contribute to the development of bad breath, as the accumulated bacteria can release unpleasant odours.

Malocclusion can also lead to temporomandibular joint disorder (TMJ), a painful condition that affects the jaw joint.[iv] TMJ can cause headaches, jaw pain, difficulty in opening and closing the mouth, and even lockjaw. When the teeth are not properly aligned, the jaw joints are forced to adapt to an unnatural position, which can lead to strain and inflammation.

Speech and wellbeing problems

Speech problems can also arise from the condition. The position of the teeth plays a crucial role in forming proper speech sounds.[v] When the teeth are misaligned, it can interfere with the formation of certain sounds, causing speech impediments like lisps or difficulty pronouncing certain words. These speech problems can have a negative impact on a person’s self-confidence and their ability to communicate effectively. It should be noted that changes in tooth shape, both due to wear and its restorative treatment, can have an effect on speech too.i

In addition to the physical problems, malocclusion can also have a significant impact on a person’s mental and emotional well-being.[vi] Many individuals with malocclusion may feel self-conscious about their smile, leading to a decrease in self-esteem. They may avoid social situations or find themselves covering their mouths when they speak or smile, which can create feelings of isolation and affect their overall quality of life.

Managing tooth wear

Another issue that can arise is abnormal tooth wear.[vii] When teeth are not properly aligned, pressure is unevenly distributed during chewing, leading to excessive wear and tear on the enamel. This can result in a shortened lifespan of the affected teeth, which may eventually require dental intervention such as fillings, restorations, or even extractions.

The restorative treatment options possible with today’s materials and techniques include conventional restorations, removable prostheses and minimal preparation adhesive restorations.[viii] Depending on the type of wear, different materials can be used. For example, lesions with margins that are still confined to the enamel would be suitable for a microfine or polishable densified composite resin (in conjunction with acid-etched enamel). While deeper cervical lesions would suit a glass ionomer cement with polishable composite resin.

Brilliant Crios from COLTENE is a reinforced composite bloc for the fabrication of permanent, indirect restorations using a CAD/CAM grinding process. Available in three translucencies (and two sizes) with a total of 15 shades, it offers a broad spectrum of solutions for aesthetic single-tooth restorations – including inlays, crowns and veneers – and is ideal for use in both the anterior and posterior regions. Brilliant Crios’ outstanding mechanical properties are the result of controlled, stress-free, thermal curing. Its multimodal composition of dental glass and amorphous silica in combination with a reinforcing resin matrix, make it an optimal material for permanent single-tooth restorations.

Malocclusion can lead to a variety of oral health problems, including difficulty in maintaining proper hygiene, TMJ disorder, speech problems, emotional distress and abnormal tooth wear. Restorative treatments can help the appearance of worn dentition, rejuvenating a patient’s smile and renewing their self-confidence. Genius!


For more information, and 0800 254 5115

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Nicolas Coomber COLTENE  National Account & Marketing Manager

[i] Daily Mirror, 30 November 2023,

[ii] Cenzato N, Nobili A, Maspero C. Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review. Dent J (Basel). 2021 Oct 11;9(10):117. doi: 10.3390/dj9100117. PMID: 34677179; PMCID: PMC8534899. [Accessed December 2023]

[iii] Pereira D, Machado V, Botelho J, Proença L, Rua J, Lemos C, Mendes JJ, Delgado AS. Impact of Malocclusion, Tooth Loss and Oral Hygiene Habits on Quality of Life in Orthodontic Patients: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2021; 18(13):7145. [Accessed December 2023]

[iv] International Journjal of Oral and Carniofacial Science

[v] Sterenborg, B.A., Kalaykova, S.I., Knuijt, S. et al. Speech changes in patients with a full rehabilitation for severe tooth wear, a first evaluation study. Clin Oral Invest 24, 3061–3067 (2020). [Accessed December 2023]

[vi] Taibah SM, Al-Hummayani FM. Effect of malocclusion on the self-esteem of adolescents. J Orthod Sci. 2017 Oct-Dec;6(4):123-128. doi: 10.4103/jos.JOS_16_17. PMID: 29119092; PMCID: PMC5655961. [Accessed December 2023]

[vii] Agnani, S., Bajaj, K., Mehta, S. & Pandey, L. (2021). Tooth wear patterns in subjects with class II division 1 and class II division 2 malocclusion. International Journal of Adolescent Medicine and Health, 33(4), 20180227.

[viii] King, P. Restoration of the worn dentition. Clin Dent Rev 1, 4 (2017).

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