Types of occlusion in dentistry and their characteristics

When the upper and lower jaws close, the dentition interacts with each other in a special way. This interaction is called "bite". How correctly the dentofacial apparatus functions depends on the nature of the closure of the dentition.

A normal or physiological bite ensures the high-quality functioning of the dental system. A person with a normal bite has clear diction, free breathing, and an attractive smile.

Pathological occlusion is a serious deviation in which the functioning of the masticatory muscles and the temporomandibular joint is impaired. As a result, the patient feels discomfort when chewing food, his teeth deteriorate, his appearance deteriorates, and his quality of life is disrupted.

In order to describe the types of disorders in the structure of the dentofacial apparatus, a classification of occlusions is carried out. There are three degrees in dentistry.

The first degree assumes a normal or physiological bite. The main signs of a normal bite: there are no pronounced gaps between the closed upper and lower teeth, their contact occurs symmetrically, the central line of the jaws coincides with the midline of the face.
The second and third degrees indicate the presence of deviations from the norm of varying intensity.

There are different types of normal and pathological occlusion.

Types of normal occlusion

According to statistics, no more than 30% of the population have a normal bite. There are several types of teeth arrangement that meet all the signs of a correct bite:

Orthognathic. The teeth of the upper jaw overlap the lower teeth by a third of the crown size. When the jaws close, close contact occurs between the teeth.
Straight. The cutting edges of the upper and lower teeth are in close contact. Correct occlusion of molars and premolars is mandatory.
Biprognathic. The upper and lower incisors have a slight inclination towards the vestibule of the mouth. There is contact between the incisors, and the upper canines slightly overlap the lower ones.
Progenic. The teeth of the lower jaw are pushed forward relative to the upper ones. The closure is maintained.

With any type of normal positioning of teeth, bite correction is not carried out, since the load on the teeth is carried out evenly. Food is chewed thoroughly, the temporomandibular joint is not overloaded.

Types of abnormal bite

Any type of abnormal bite is characterized by the presence of gaps between the teeth of the upper and lower jaw. Lack of contact creates problems when chewing food, diction is impaired, and the oval of the face changes.

Open is characterized by the presence of areas of non-closure in the anterior or lateral areas of the dentition. It is manifested by the presence of a gap between the teeth of the upper and lower jaw, non-closure of the lips, leading to disruption of the functions of chewing, breathing, and diction.
Deep . The teeth of the upper dentition overlap the lower ones by more than 30% of the crown height. The most common type of abnormal bite. A strong degree of pathology leads to constant trauma to the mucous membrane of the gums, which is why this type of bite is called traumatic.
Distal . It is characterized by protrusion of the upper dentition in relation to the lower one due to abnormal development of the upper jaw (or underdevelopment of the lower jaw). External signs are a sloping chin, shortening of the upper lip and retraction of the lower lip. The upper and lower incisors do not have contact, and the lateral ones do not close correctly.
Cross is characterized by the crossing of the dentition when closing. Characteristic signs are facial asymmetry as a result of uneven development of the jaw areas. The patient complains of diction defects, accidental biting of the inner cheeks and pain when chewing.
Mesial . It is characterized by the advancement of the lower dentition as a result of underdevelopment of the upper jaw or abnormal development of the lower jaw. Poor contact between the teeth of the lower and upper jaw leads to dysfunction of chewing and speech. Externally, the anomaly is manifested by the presence of a massive chin, a receding upper lip, and a concave face profile.

Dividing each type of abnormal bite into separate subcategories helps determine the degree and nature of the pathology.

If there are even minimal deviations, you should consult an orthodontist for advice. Pathology of the dentofacial apparatus has a tendency to progress and develop complications from the gastrointestinal tract.

What affects the bite of teeth?

The negative impact of defects in the dental system on the condition of the entire organism has been repeatedly proven by scientists. The list of identified health risks is impressive even for ardent optimists.

Due to improper distribution of the chewing load, tooth enamel wears off faster, teeth begin to react painfully to cold and hot, their necks become exposed, and noticeable gaps form between the teeth.
Diseases of the temporomandibular joints occur, accompanied by headaches and a characteristic clicking sound when the jaws move.
The aesthetics of the face suffers: its proportions change, wrinkles form, teeth become crooked, and the smile becomes unattractive.
It becomes difficult to bite food, chewing functions are disrupted, causing diseases of the gastrointestinal tract.
Speech defects appear, facial expressions are distorted, and self-esteem decreases.
Crowding and crooked teeth cause accelerated tooth decay due to frequent chipping and carious lesions.
The oral mucosa is injured - cheeks, gums, tongue, and the tissues of the oral cavity become inflamed.
The quality of breathing deteriorates, which leads to diseases of the nasopharynx, trachea, and hearing aid.

Causes of pathological bite

The formation of occlusion is a long and complex process that begins at the stage of intrauterine development, continues in early childhood and ends after the end of puberty. Pathological occlusion is the result of long-term influence of a number of unfavorable external or internal factors at different periods of a person’s life:

Genetic factor. A genetically determined anomaly is formed when there is a congenital discrepancy in the size of the teeth and dentofacial bones (crowding of teeth or the presence of spaces between teeth) or a hereditarily determined abnormal shape and size of the lower and upper jaws.
The influence of negative factors on the body of a pregnant woman. The formation of the dental apparatus in the fetus can be influenced by bad habits, poor nutrition and diseases suffered by a woman during pregnancy.
Birth injury. During childbirth, the baby may receive injuries leading to displacement of the temporomandibular joint.
Negative factors affecting the baby’s body in the first years of life. The reason for the formation of a distal bite may be the incorrect selection of nipples or the late introduction of solid foods into the diet.
Bad habits and behavioral factors in early childhood. The habit of sucking a pacifier or finger, or sleeping with the head thrown back can cause a child to develop a deep bite.
Factors influencing the formation of anomalies in later life. These include carious lesions of the teeth, ENT pathologies, deviated nasal septum, and diseases of the skeletal system.

Treatment of abnormal bite should begin as early as possible. Early diagnosis and therapy make it possible to restore the normal functioning of the dentofacial apparatus more effectively. Doctors at the Consilium-Dent use specially developed diagnostic tests and tables. They are used both for direct examination of the oral cavity and for diagnosis using dental casts.

The need for a particular therapeutic measure is determined by a specialist based on the diagnostic results on an individual basis. You cannot resort to self-medication in this situation. This can lead to activation of the pathological process.

Bite after wisdom tooth removal

Some doctors are convinced that wisdom teeth are an atavism and must be gotten rid of. In ancient times, they were used to chew tough foods, such as raw meat. With the development of civilization, the human diet changed, his jaw began to gradually decrease - and the “eights” turned out to be superfluous. Most often, before starting to correct the bite, wisdom teeth are removed. This frees up space for the correct formation of rows, and the result of teeth alignment will be much better.

Common types of malocclusions

The most common anomalies of the dental system include deep bite. A severe degree of pathology is characterized by a situation where the upper row of teeth completely overlaps the lower row. When the jaws are closed, the upper incisors can injure the mucous membrane of the lower gums. Therefore, this type of anomaly is called a traumatic bite.

A deep bite is accompanied by a violation of facial aesthetics, impaired diction, poor quality of chewing food, and increased abrasion of the enamel.

There are two degrees of development of pathology. They are caused by various provoking factors and are characterized by different forms of manifestation:

Primary deep bite is often due to genetic reasons and is determined by the special structure of the facial bones. It manifests itself as pathological changes in the area of the dentition, alveolar process and basal part of the jaws. The movement of the jaws is blocked, and the patient experiences significant discomfort when chewing.
Secondary deep bite is acquired in nature and is a consequence of a disease or injury. As a result of a decrease in the interalveolar distance and the lower third of the face, a deep traumatic closure of the incisors develops.

Another type of pathology classification is carried out depending on the nature of the interaction of the lateral teeth.

A deep distal bite is characterized by the overlap of the lower row of teeth with the upper ones by more than one third of the length of the crown with a violation of the relationship of the lateral teeth. Characteristic disorders include difficulty biting and chewing, breathing problems, and pain in the temporomandibular joint.
Deep neutral bite: when the overlap of the lower front teeth with the upper ones is disturbed, while the position of the lateral teeth is not disturbed.

If you experience even minor discomfort when chewing, you should immediately contact a specialist and follow his recommendations.

The presence of a malocclusion or a predisposition to it is determined by an orthodontist after an initial examination using special tests. Self-diagnosis does not provide an objective picture of the condition of the dentofacial apparatus, since different pathologies may have the same symptoms. Treatment in this case will be radically different.

If there are no problems with your bite, you should visit the orthodontist for a preventive examination approximately once every six months. The doctor will determine whether there is a tendency to a particular anomaly even before the problem is noticeable.

How to identify malocclusion

In most cases, malocclusions are easily recognized by an experienced doctor during a routine visual examination. But there are situations when part of the row has not yet been cut through. In this case, additional examination may be required to find incorrect teeth and determine whether there is any risk of developing serious pathologies.

Teeth that have not fully erupted are called impacted. Read in detail about them in our article: “What are impacted teeth, why do they appear and how to treat them...”

Malocclusion in adults and children is diagnosed using the following research methods:

panoramic photograph of the jaw;
CT scan of the jaw;
teleroentgenogram (TRG image).

The listed materials provide an experienced doctor with enough information to identify bite problems and create an up-to-date treatment plan.

Different types of bite studies

The importance of routine observations in normal occlusion

In children with an orthognathic or straight bite, the arrangement of dental units in a row may change due to untimely (early or late) change of primary teeth. During a preventive examination, the orthodontist will identify the presence of abnormalities in the rudiment itself. The following types of preventive measures are carried out:

Clinical examination (allows us to identify existing anomalies and risk factors).
Formation of groups of patients for further clinical observation.
Drawing up a plan of preventive and therapeutic measures (pediatricians of all profiles participate).

In adult patients with normal dentition, malocclusion can develop under the influence of external and internal unfavorable factors. The main reasons that increase the risk of developing dental anomalies in adults are:

carious process;
loss of teeth;
various types of prosthetics;
prosthetics errors;
bad habits.

During the examination, the dentist will identify the presence of predisposing factors, after which he will develop a scheme for carrying out preventive measures to maintain a normal bite. Selection is carried out on an individual basis, taking into account the condition of the dental system and the physiological characteristics of the patient’s body.

How to correct an overbite

Modern dentistry has come up with dozens of ways to correct malocclusion. Most often, braces are used, followed by retainers to prevent teeth from moving apart. Other adjustment methods:

wearing trainers;
use of records;
aligners and aligners;
surgical intervention.

An orthodontist is involved in the treatment of malocclusion, about whose work we wrote a separate article. Read more about treatment and diagnostics here: “What an orthodontist treats: what diseases does this doctor treat…”

Treatment of malocclusions

Before prescribing treatment procedures, the orthodontist assesses the condition of the oral cavity, carefully examines the depth of the problem and the presence of concomitant pathologies, taking into account the patient’s age. Treatment of dental anomalies is carried out using conservative and radical methods:

Braces are the most popular method of bite correction. This orthodontic method has the widest range of applications and is suitable for solving any problem of malocclusion. Treatment with this method is long and includes preparatory, main and retention (recovery) periods.
Aligners. Removable structures are used to treat the initial stages of deviation. With their help, a gentle correction of the dentoalveolar apparatus is carried out, changing one set of mouthguards to another.
Application of veneers, onlays, crowns. Weak areas of the dentition that are susceptible to caries are protected by using orthopedic structures. Chipped areas of enamel are restored using ceramic onlays and veneers.
Surgical intervention is performed to treat late stages of dental anomalies (mainly of a hereditary nature). During the operation, the position of the jaws is changed, their size is reduced or increased.

Laser therapy is performed as an auxiliary treatment to help speed up regeneration and reduce the risk of complications.

Correction methods

Modern orthodontics offers a wide arsenal of instruments, accessories and treatment techniques that can eliminate occlusion disorders.

Orthodontic plate. A removable device for straightening teeth, consisting of a plastic base that fits tightly to the palate or gum, and metal clamps that gradually shift the tooth into the desired position.
Braces. Fixed structures that are considered effective for correcting almost all types of malocclusion. Braces can be made of metal, ceramic or plastic.
Trainers. These are removable dental splints made of silicone or polyurethane. Correcting the position of teeth with trainers includes three stages: preparatory, main and consolidating, each stage takes about six months.
Aligners. Transparent removable orthodontic structures made of hypoallergenic plastics, in many cases capable of replacing fashionable braces. Aligners are made individually, based on impressions of the patient’s teeth or the results of a digital scan of the jaw.

Orthodontic devices for bite correction
In exceptional cases, in the presence of serious occlusion disorders that have developed due to congenital pathologies of the structure of the skull bones or after jaw deformation as a result of trauma, when it is clear that non-invasive methods for correcting occlusion anomalies will not be effective, surgical intervention is indicated.

Types of prevention of malocclusions

Prevention of malocclusion in childhood is very important, as it determines whether the child will have problems in the future. Adults should monitor the eruption of permanent teeth in children and visit an orthodontist with the child for timely detection of anomalies and bite correction.

Prevention of malocclusions involves eliminating bad habits that cause one or another anomaly: lip biting, finger sucking in children. To do this, special plates are used that block the ability to use a bad habit. In adults, such methods help cure abnormalities in the early stages.

It is important to carry out sanitation of the oral cavity in a timely manner and periodically come for medical examinations to the dentist. Children from the age of six months should be taught to chew solid food.

A good method of prevention is specially designed therapeutic exercises. When performing exercises, the patient puts the correct load on the jaw muscles, which contributes to the harmonious development of the maxillofacial system.

Bite formation in children

At the stage of bite formation in children, there are three most important periods:

The milk bite begins to form at six months of age and continues until 3 years of age. This is the initial stage during which the foundation for the formation of a permanent bite is laid.
The change to a permanent dentition lasts up to 9 years. During this period, the jaws actively develop and a permanent bite begins to form. During this period, when the dentition consists of baby and permanent teeth, children often develop malocclusions. Common causes are a violation of the pairing of teeth erupting with an unequal degree of development of the jaw sections.
The formation of a permanent bite occurs from 12 to 15 years. The replacement of baby teeth ends, permanent teeth complete their growth and are installed in their permanent places.

Consequences of malocclusion

Each age has its own critical effects that incorrect teeth can have on the human body. But while in an adult the influence is often unnoticeable, in a child it can lead to developmental anomalies in many systems and organs. That is why it is important to remember what will happen if the bite is not corrected, and to deal with the problem in a timely manner.

Temporary

The temporary bite is formed from 6 months to 6 years. The process usually takes place in two stages: first, the primary teeth erupt. With proper development of the child, this stage ends around 3 years, after which active growth of the jaws begins. This period is a kind of preparation for the eruption of permanent teeth.

Abnormal development of the upper and lower jaw

Incorrect temporary bite usually occurs due to disturbances during pregnancy, birth injuries and poor heredity. Problems also appear if the child does not want to give up the pacifier, replaces it with a finger in the mouth, or has breathing problems.

The most important consequence of malocclusion of primary teeth is underdevelopment of the jaws. The child's body simply does not understand what size they should be and stops jaw growth too early. There is also the opposite case, when the oral apparatus turns out to be overly developed and massive. If left untreated, the problem will cause permanent teeth to erupt improperly.

Removable

A mixed bite is called a removable bite, in which some of the baby teeth have not yet been replaced by permanent ones. There is an early mixed dentition, which is formed at 6-9 years of age. The first to be replaced are the molars, and behind the baby teeth the first permanent molars, the “sixes,” appear. Late mixed dentition begins to form at 10 years of age. At this age, premolars and canines grow. With a correct change of bite, the permanent teeth do not come into contact with the milk teeth and quickly take their place.

Irregular eruption of permanent teeth

Dental disorders in the mixed dentition are caused by elements that fall out or are removed too early: they leave cavities and gaps, which is why the formed permanent teeth grow without the correct orientation. This can cause twisting, incorrect placement of teeth in space and other problems. This is why baby teeth need to be treated rather than removed.

Constant

At the age of 12-15, a person’s milk teeth are replaced by permanent ones, and most of the molars, except for the “eights,” also grow. At this age we can talk about a fully formed permanent dentition. If baby teeth grow correctly, we can hope that the molars will also be positioned correctly. Although this is not a guarantee, this is often the case. But, if a person has developed an incorrect bite, the consequences cannot be avoided.

Decreased chewing activity

Malocclusion almost always leads to a decrease in chewing activity. The teeth do not touch each other, so a person simply cannot provide sufficient force to chew food. He makes a lot of movements without getting the desired result, and as a result, he often refuses to chew properly at all. Because of this, large pieces of food enter the stomach, which are difficult for the body to process; a person does not receive enough nutrients from food.

Temporomandibular joint disease

The temporomandibular joint is one of the most mobile in the human body. But it also cannot withstand too much stress. If the teeth are positioned incorrectly and the chewing function is impaired, overload cannot be avoided. Also, improper bite of the teeth causes disturbances in movement in the joint, the appearance of clicks, and pain. In the most negative version, the TMJ becomes completely stuck: the person opens his mouth, but cannot close it.

Uneven chewing load on teeth

One of the signs of a correct bite is an even load on the teeth. When chewing, each molar and premolar performs its function by cutting or grinding food particles. The absence of an element in the dentition or their weak contact leads to the fact that one tooth “works” and the other does not. This is especially noticeable in an open bite.

Increased enamel wear

Uneven loading invariably leads to frequent use of the same tooth surfaces. Because of this, the enamel suffers, which is damaged in certain places and begins to wear off faster. Weakening and abrasion of enamel almost always causes tooth disease.

Damage to bone tissue

Damage to bone tissue is almost always caused by the absence of one of the elements in the bite. If there is no tooth, the load that it took upon itself falls on the bone. Due to the formation of the cavity, chewing mainly occurs with adjacent molars or canines, but such disorders also have a great impact on bone tissue.

Periodontitis

Gum inflammation is almost always associated with a malocclusion. And the stronger the disorder, the more often inflammation will occur. They are especially familiar to people who have crooked teeth. Periodontitis can also occur due to constant damage to the gums by food or adjacent elements of the dentition.

Early tooth loss

It is possible to lose teeth early even with a normal bite, but due to increased wear of the enamel, the risk of developing caries and other diseases increases. This leads to early destruction of the crown, and even to inflammation of the pulp.

Impaired diction

Diction disorders due to malocclusion are usually associated with the fact that a person cannot ensure the necessary passage of air through the oral cavity. But it is precisely this action that makes it possible to pronounce some sounds correctly. If there is no barrier in the form of teeth, speech sounds incorrect.

Aesthetic violations

While a small deep bite may not be noticeable, a cross bite is immediately visible and looks very unaesthetic. Violations extend not only to the teeth hidden in the mouth, but also to the facial skeleton. Facial asymmetry is a common consequence of malocclusion.

Gastrointestinal diseases

Gastrointestinal diseases most often occur after a long life with dental disorders. The problem is related to insufficient chewing of food. The gastrointestinal tract has to take on the function of teeth, processing too large pieces of food. This leads to rapid wear and tear of organs.

Difficult oral hygiene

Uneven teeth are very difficult to clean. Due to the appearance of too small or too large gaps between the teeth, cavities appear that are inaccessible to the brush, where bacteria accumulate. Only an irrigator or dentist can help ensure an adequate level of hygiene.

Difficult prosthetics and restoration

Most orthodontic surgeries are simply not performed for malocclusions, as there is no point in them. Tooth restoration is available, but chewing disorders and excessive stress will lead to rapid wear of the prosthesis. That is why most dentists first recommend correcting the bite, and then doing restoration.

Breathing problems

The airways are located in the lower jaw area. If it is displaced, then the person cannot breathe fully. This can cause snoring and even nighttime breathing apnea.

Bruxism

Bruxism is excessive clenching of teeth and grinding. It occurs due to problems with the temporomandibular joint, as well as if the dentition is positioned incorrectly. Bruxism is a complex problem and can occur for other reasons, but malocclusions cause it quite often.

ENT diseases

The appearance of various ENT diseases is usually associated with constant inflammation in the oral cavity. Both systems are nearby, so inflammatory processes in the mouth quickly spread to the nasopharynx. And they appear in the mouth due to lack of care and a good environment for the development of bacteria.

Traumatization of soft tissues of the oral cavity

Soft tissue injury usually occurs if one of the teeth is positioned incorrectly. It can be moved forward or to the side. The sharp edge often scratches the mucous membrane, causing non-healing abscesses to appear on it. The problem can be solved locally: just sharpen the tooth.

Gum recession

Gum recession is the exposure of the root portion of the tooth. It usually occurs due to improperly distributed chewing load. Because of this, the teeth themselves become much more sensitive, and inflammation occurs.