Classification

• Malocclusions can be broken into three classifications. With a Class I malocclusion, the lower teeth are slightly overlapped by the upper teeth and the bite is normal. Class I is the most common form. When the bottom teeth and jaw are severely overlapped, a Class II malocclusion, or overbite, occurs. A Class III malocclusion, or underbite, occurs when the lower jaw and teeth overlap the upper teeth. This is caused when the lower jaw pushes forward.
  
  

Causes

• While heredity is the most frequent cause, there are several other conditions that may cause malocclusion pain: variations in the sizes of the upper and lower jaws, or jaw and tooth size; birth defects, such as a cleft lip or cleft palate; dental procedures such as ill-fitting corrective appliances and misaligned jaw fractures; and mouth and jaw tumors. Malocclusion may also occur when children suck their thumbs, thrust their tongues, or extensively use a pacifier or bottle.
  
  

Symptoms

• Malocclusion makes biting and chewing difficult, which may lead the jaw into uncomfortable positions that may cause muscle fatigue, jaw pain, and migraines. This difficulty in chewing will also wear down teeth and damage gums, and may eventually lead to tooth loss. Other symptoms can include an abnormal facial appearance, speech difficulties, tooth decay, and mouth breathing.
  
  

Diagnosis

• Teeth alignment problems are often discovered by dentists during routine exams. During the exam, the dentist will pull the patient's cheek outward and have the patient bite down to examine how well the back teeth come together. If a misalignment is observed, the dentist will refer the patient to an orthodontist. The orthodontist may use dental, head, or facial X-rays for further diagnosis.
  
  

Treatment

• The National Institute of Health service, Medline Plus, suggests that the goal of malocclusion treatment is to correct the teeth's alignment. Correct alignment will indirectly alleviate pain. Braces are the primary dental appliance used to correct teeth positioning. Patients may need to wear a retainer indefinitely to maintain the new positioning. Correcting the alignment makes cleaning teeth easier, which reduces the risk of tooth decay and periodontal disease. Direct pain alleviation includes: lengthening or shortening the jaw bone; stabilizing the jaw with plates or screws, or myofascial massage of the jaw muscles.