Crooked Teeth

Causes of Crooked Teeth

Crooked teeth are a prevalent issue among children and adults. In children, misaligned teeth can occur because their teeth are too small to fit fully in their gum space. Genetics also play a role in crooked teeth in minors. Additionally, prolonged behaviours such as using a pacifier or thumb sucking can lead to teeth misalignment.

While a child may have misaligned teeth, it doesn’t necessarily mean that their teeth will remain crooked into adulthood. However, if the child has crowded teeth, their permanent teeth might also be crowded. Tooth decay can cause teeth to fall out earlier than they naturally would, leading to misalignment in the permanent teeth that follow.

Factors that can contribute to crooked permanent teeth include:

• Jaw size: Modern diets, which often include more processed foods requiring less chewing, are believed by some researchers to have contributed to smaller jaw sizes. A shorter or smaller jaw can result in misaligned, crooked, or crowded teeth.
• Genes and heredity: A person is at higher risk of having crooked or crowded teeth if one or both parents have/had the same condition. Overbites and underbites can also be inherited from parents.
• Malocclusion: This refers to misaligned jaws occurring when the upper teeth do not properly fit over the lower teeth as they should. Typically, the upper teeth should fit slightly over the lower teeth, with the upper molars fitting into the grooves of the lower molars.
  
  Malocclusions can present as overbites or underbites. An overbite occurs when the upper front teeth protrude above the lower front teeth. Conversely, an underbite arises when the lower front teeth stick out more compared to the upper front teeth. These can result from poor myofunctional behaviours like thumb sucking.
• Poor myofunctional habits: Myofunctional behaviours such as thumb sucking, prolonged use of a pacifier or feeding bottle, tongue thrusting, and mouth breathing are likely to impact the functions and muscles of the mouth or face, potentially leading to crooked teeth.
• Poor dental care: Certain dental problems, such as gum disease, might not be identified and addressed if your teeth are not routinely examined by a dentist. This can lead to teeth misalignment and other dental health issues.
• Poor nutrition: Inadequate nutrition can lead to tooth decay and poor dental growth, particularly in children. Over time, this can contribute to crooked teeth.
• Facial injury: Facial trauma or injury can cause one or more misaligned teeth. A blow to the mouth or face can knock teeth out of position.

Effects of Crooked Teeth

If you have crooked teeth, you may experience painful chewing. This can also make you self-conscious about your smile or potentially lead to avoiding certain social situations. Additional effects of misaligned teeth include:

• Difficulty chewing: Trouble chewing can lead to digestive issues.
• Speech problems: Misaligned teeth can alter how you pronounce sounds, affecting your speech.
• Wear and tear: Misaligned teeth can cause excessive wear on gums, teeth, and jaw muscles, potentially leading to cracked teeth, jaw strain, and temporomandibular joint disorder.
• Periodontal disease: Crooked teeth can make it difficult to clean between them, increasing the risk of periodontal diseases like gum disease and tooth decay.
• Low self-esteem: Crooked teeth can affect self-esteem, causing frustration with one’s physical appearance.

Should Crooked Teeth Be Straightened?

Deciding to straighten crooked teeth is often a personal choice. Many individuals with misaligned teeth experience low self-esteem and are self-conscious about their smiles. The decision to align teeth can be influenced by cost, as insufficient funds or lack of dental health cover might prevent some from undergoing treatment. Health problems may also affect the decision.

Some individuals might choose not to straighten their teeth if they are comfortable and are not concerned about displaying their imperfect teeth. For instance, in Japan, a slightly crooked canine tooth is known as ‘yaeba’ and is considered an attractive feature among women.

Diagnosis

People with crooked teeth should visit an orthodontist for an examination of their teeth, jaw, and mouth. The orthodontist will inquire about symptoms, such as physical pain when chewing or popping noises when opening or closing the mouth. Additionally, they will perform an X-ray of the mouth and create a mould of the teeth for assessment.

Options for Straightening Teeth

There are numerous options available for straightening crooked teeth. You should consult with your orthodontist for more details. The possible treatment options include braces and teeth-straightening surgery.

• Braces: Orthodontists can suggest using braces to straighten teeth for individuals of any age, provided they have strong teeth and gums to support them. Straightening crooked teeth with braces is usually easier in children since their gums and bone tissues are still flexible.

There are various types of braces available. The duration of treatment depends on the kind of braces used, with some treatments taking about two to three years. Types of braces include:

• Metal braces: Metal braces consist of metal brackets fastened to the teeth with a flexible wire and bands. They are commonly recommended for more complex dental alignment problems. Metal braces have been adjusted to include less metal and smaller brackets, making them much more comfortable than before. They are available in various colours to match one’s personality and are more affordable than other braces.
• Ceramic braces: Ceramic braces have archwires that match the colour of the teeth. They follow the same teeth-straightening process as metal braces but tend to break and stain more easily. They are less noticeable than metal braces but are more costly.
• Invisible braces: Invisible braces, ideal for teenagers and adults, are almost invisible when worn. They consist of Invisalign and clear plastic aligners customised to fit the mouth. These braces are more comfortable compared to traditional ones and do not need to be removed when eating certain foods. They fit over each tooth like a mouth guard and gradually move teeth into position. Invisalign braces require removal and replacement with a new set every two weeks to accommodate the gaps formed as teeth move into place. However, orthodontists may not recommend these braces for severely crooked teeth.
• Lingual braces: Lingual braces are placed on the inside of the teeth. They are also invisible but are very costly and difficult to clean. Lingual braces may not be suitable for all types of crooked or misaligned teeth.

Teeth-Straightening Surgery

Besides braces, surgery is another option for people with crooked teeth. Since it requires a shorter period, it is a preferable option for those who cannot tolerate long-term discomfort from braces. This surgical procedure may involve repositioning gums and bones to hold teeth in place.

Teeth-straightening surgery is suitable for complex misalignment issues such as jaw alignment. Often referred to as orthognathic surgery, this procedure may be recommended for individuals with seriously crooked teeth that impact their chewing ability or speech.

What to Expect When Visiting a Dentist or Orthodontist

The dentist might refer you to an orthodontist, who will examine your teeth, jaw, and mouth, and assess your bite. The orthodontist will also ask about any symptoms you are experiencing, including popping sounds when opening or closing your mouth and physical discomfort when chewing or at other times. They will conduct X-rays of your mouth and create a mould of your teeth for further analysis.

Takeaway

Crooked teeth are a common issue affecting many children, teenagers, and adults. Treatment is usually only necessary if the condition causes health or self-esteem problems. The choice to correct misaligned teeth is personal. If cost is a concern, consider discussing it with your orthodontist, as programs like MD.co.uk might help with the treatment.