Table of Contents
Misalignment can occur due to several reasons such as heredity, environmental factors both prenatal and postnatal, infectious diseases, nutritional deficiencies, abnormal pressure habits etc. Some of them are preventable whereas others need proper treatment. So, one must know the various reasons of crooked teeth and the treatment to avoid many direct or indirect problems occurring due to them.
Common Reasons of Crooked Teeth
Causes of crooked teeth depend upon which part of mouth is involved. There are many reasons: ranging from genetic to various environmental factors. Basically mal-alignment of teeth can occur due to malposition of individual tooth, malrelation of the jaws and imbalanced growth of jaws and teeth. There are various reasons which can cause malposition of teeth such as missing teeth, extra teeth, premature loss of milk teeth, over retention of milk teeth etc. Malrelation of the jaws can occur due to various reasons. Some of the reasons are preventable.
1. Children around the age of 9- 12 years
In children around the age of 9- 12 years, when the canine teeth is erupting, temporarily mal-alignment of teeth can occur. It occurs due to pressure from the erupting teeth. This condition is temporary and after eruption of teeth, it goes. This condition does not need any treatment.
2. Disproportion of Size between Teeth and Jaw bone
Disproportion of size between teeth and jaw can occur due to large or small size of teeth than normal, or relatively large or small size of teeth than jaw, or large or small size of jaw. It can be inherited. Also, it can occur due to various diseases or infections during tooth development. Some diseases such as congenital syphilis etc can cause small size of teeth, whereas other diseases such as gigantism etc cause large teeth size which then causes mal-alignment of teeth. Some syndromes such as crouzon syndrome etc cause under development of jaw and thereby cause mal- alignment of teeth. Abnormal shape of the teeth may also cause misalignment of the teeth and may affect the orthodontic treatment.
3. Missing Teeth
Missing teeth can occur due to absence of few or all teeth. In some hereditary conditions such as ectodermal dysplasia there can be absence of many or all teeth. Missing teeth can lead to gaps between teeth, aberrant swallowing patterns, abnormal tilting of teeth etc. If the teeth are missing and causing mal-aligned teeth, replacement of the teeth is needed.
4. Extra Teeth or Supernumerary Teeth
Due to various reasons, extra number of teeth can occur. In some syndromes such as gardener syndrome etc, numerous extra teeth can occur. Extra teeth can cause non- eruption of adjacent teeth, delay the eruption of adjacent teeth, deflect the eruption of adjacent teeth, crowding of teeth etc. It then lead to mal- alignment of teeth.
5. Premature Loss or Prolonged Retention of Milk Teeth
Premature loss of milk tooth can occur due to various reasons such as trauma, dental caries etc. If the succedaneous tooth is not sufficiently close to the point of eruption, it may cause misalignment of teeth. When permanent tooth does not erupt for some time following the loss of milk tooth, the adjacent tooth may migrate into that space and ultimately mal-positioning of teeth.
Prolonged retention of milk teeth can occur due to hormonal imbalances, infections, trauma, nutritional deficiencies, genetic, syndromes, radiation etc. Whichever milk tooth is retained beyond the normal age of eruption of permanent tooth, is capable of causing deflection in the path of eruption of permanent tooth, non-eruption or impaction of permanent tooth etc. This lead to misalignment of teeth or crooked teeth.
6. Traumatic Injuries
Trauma to the milk teeth can lead to premature loss of the same and may also cause injury to the developing permanent tooth. Injury to the developing permanent tooth can lead to defect in their development and can cause misalignment. Similarly, trauma to the permanent tooth may also cause loss of the tooth. If not treated on time, can lead to crooked teeth.
7. Loss of Permanent Teeth
Loss of permanent teeth can occur mainly due to trauma, dental caries or gum diseases. If not replaced on time, the adjacent tooth may shift in that space causing misalignment of teeth.
8. Endocrine imbalance and Other disturbances/ Infections
Endocrine imbalances such as dysfunction of pituitary glands, thyroid, parathyroid glands etc may cause retardation of jaw growth, delayed eruption of teeth, early exfoliation of milk teeth, abnormal size of teeth etc, which can cause misalignment of teeth. Other disturbances or infections such as rubella, measles, chicken pox, tuberculosis etc may also affect the growth and development of teeth and jaw. And, can cause misalignment of teeth.
9. Nutritional deficiencies
Nutritional imbalances and deficiencies such as excess vitamin A, D and deficiencies of vitamin A, B, C, D, protein, insulin, iodine etc affects the growth and development of both the teeth and jaw. So, they can cause misalignment of teeth. By taking proper nutrition, one can avoid these problems.
10. Abnormal Pressure Habits
Oral habits or abnormal pressure habits such as thumb/ digit sucking, lip sucking, tongue thrusting, mouth breathing, nail biting, bruxism etc tend to cause misalignment of teeth. All these habits lead to an imbalance in the forces acting on the teeth, thereby causing their misalignment. Oral habits also lead to abnormal position of the tongue and also affect the surrounding muscles.
Treatment of Crooked Teeth
Prevention is not only better than cure but cheaper as well. The proper time to begin treatment of crooked teeth is as near to the beginning of variation from normal, as possible. Not only to improve aesthetics and pleasant smile but also to maintain dental and oral health, treatment of crooked teeth should be done. Let’s see the various treatment plans and preventive measures.
1. Management of Abnormal Pressure Habits/ Oral Habits
Management of various abnormal pressure habits is very important for the prevention of crooked teeth.
- Tongue thrusting habit- This habit is related to prolonged breast feeding or bottle feeding by mother. So, it should be withdrawn by 18- 24 months of age.
- Thumb sucking or digit sucking or lip sucking habit– The child should be distracted from indulging in the same.
- Mouth Breathing– Adequate medical attention regarding the upper respiratory tract infections or abnormalities can help in prevention of this habit. Some myofunctional appliances such as pre-orthodontic trainers, train the child to breathe through the nose. Thus, it allows the proper development of nasal passage, and the development of palate, preventing the misalignment of teeth.
- Muscle exercises, stretchings etc also help to create normal health and function of surrounding muscles and aid in the treatment of crooked teeth due to such habits.
2. Removable Orthodontic Appliances
Removable appliances can be removed by the patient. So, to get the best out of it, the prime requirement is the co-operation of the person. Consultation from the orthodontist is required for proper treatment planning.
- Space maintainers– They can be either removable or fixed. This appliance helps to maintain the space due to premature loss of milk tooth. Thereby it helps in prevention of misalignment of teeth.
- Removable orthodontic appliances are also helpful in regaining the space lost due to premature loss of milk tooth. Also, they help in proper alignment of teeth especially in growth stage.
3. Fixed Orthodontic Appliances or Braces
Fixed orthodontic appliances cannot be removed by the patient. Even with limited co-operation from the patient, fixed appliances can give the best results. Treatment with fixed appliances or braces needs proper treatment planning by the orthodontist.
4. Orthopedic Appliances
Orthopedic appliances mainly help in the treatment of jaw or skeletal discrepancies. These appliances usually give best results when the jaw is developing that is during childhood and teenagers. Proper diagnosis and treatment planning is necessary for the best treatment. So, for best treatment one must take consultation as early as the abnormality is detected.
If there is a major discrepancy of jaws or skeletal and it is not corrected in the childhood, then surgery can help. Surgery is usually done in adults, after stoppage of jaw growth. Surgical treatment needs proper planning and diagnosis. So, one must take consultation from orthodontist for surgical correction.
Crooked teeth is one of the common dental problem especially in children. If not corrected on time, they may cause more problems afterwards. As, misalignment of teeth may lead to many problems other than aesthetics, they should be taken care of properly. One must take consultation from orthodontist for proper diagnosis and treatment of crooked teeth.