Malocclusion is the medical term for a bite problem, where the upper and lower teeth do not fit together properly when the mouth is closed. It can involve crooked teeth, crowded teeth, gaps between teeth, or jaw misalignment.
Some forms of malocclusion are mild and mainly affect appearance, while others can interfere with chewing, speaking, oral hygiene, and jaw development. Early diagnosis by a pediatric dentist or orthodontist can often guide your child’s growing teeth and jaws, making treatment simpler and more effective, especially when caught during regular dental checkups.
What Is Malocclusion?
Normally, the upper teeth sit slightly in front of the lower teeth, allowing the jaws to bite together comfortably.
With malocclusion, the teeth or jaws are not properly aligned. This can affect:
- Tooth alignment.
- Jaw position.
- The way the teeth come together.
- Facial growth and development.
Malocclusion may involve baby teeth (primary teeth), permanent teeth, or the mixed dentition stage, when children have both baby and adult teeth.
How Common Is Malocclusion in Children?
Malocclusion is one of the most common oral health conditions worldwide.
The World Health Organization considers it the third most common oral health problem, after tooth decay and gum disease.
Studies estimate that more than half of children have some degree of malocclusion. Fortunately, many bite problems can be identified early and managed before they become more complex.
Types of Malocclusion
Class I, II, and III Malocclusion (Angle’s Classification)
Orthodontists commonly use Angle’s Classification to describe bite problems.
| Type | Description |
| Class I Malocclusion | The molars are correctly aligned, but there may be crowding, spacing, or rotated teeth. |
| Class II Malocclusion | The upper teeth or upper jaw sit too far forward compared with the lower jaw, often creating a noticeable overbite or overjet. |
| Class III Malocclusion | The lower jaw sits in front of the upper jaw, resulting in an underbite. |
Overbite and Overjet
Although often confused, these are different conditions.
- Overbite refers to how much the upper teeth vertically overlap the lower teeth.
- Overjet describes how far the upper front teeth project forward.
Underbite
An underbite occurs when the lower teeth extend in front of the upper teeth.
This may affect:
- Chewing.
- Speech.
- Jaw growth.
- Facial appearance.
Crossbite
A crossbite happens when some upper teeth bite inside the lower teeth.
It may involve:
- Front teeth (anterior crossbite).
- Back teeth (posterior crossbite).
Without treatment, a crossbite can influence jaw growth over time.
Open Bite
An open bite means the upper and lower front teeth do not touch when the mouth closes.
It is commonly associated with:
- Thumb sucking.
- Prolonged pacifier use.
- Tongue thrusting.
Crowding and Spacing
Crowding develops when there is not enough room for all the teeth.
Spacing occurs when there are gaps between teeth, including a noticeable diastema between the upper front teeth.
What Causes Malocclusion in Children?
Several factors can contribute to bite problems.
Genetics
Many children inherit:
- Jaw size.
- Tooth size.
- Facial growth patterns.
If parents required orthodontic treatment, their children may also be more likely to develop malocclusion.
Thumb Sucking and Pacifier Use
Thumb sucking and pacifier use are normal during infancy.
However, if these habits continue beyond 4 to 5 years of age, they may affect tooth and jaw development.
Tongue Thrust and Mouth Breathing
Children who consistently push their tongue against their teeth or breathe through their mouth may develop changes in jaw growth and tooth position.
Early or Late Loss of Baby Teeth
Baby teeth act as natural space holders for permanent teeth.
Losing them too early or keeping them for too long can cause neighboring teeth to drift, increasing the risk of crowding and other bite problems.
Signs and Symptoms to Watch For
Parents may notice:
- Crooked teeth.
- Crowded teeth.
- Gaps between teeth.
- Difficulty chewing.
- Speech difficulties.
- Mouth breathing.
- Frequent biting of the cheeks.
- Teeth that do not meet properly.
- Jaw clicking or discomfort.
Some children may have no obvious symptoms until permanent teeth begin to erupt.
Why Treating Malocclusion Matters
Speech and Chewing Difficulties
A poor bite can make chewing less efficient and may contribute to speech difficulties in some children.
Jaw Pain and TMJ Problems
Improper bite alignment can place additional stress on the temporomandibular joints (TMJ), potentially leading to discomfort or jaw fatigue, similar to the jaw strain seen with teeth grinding in children.
Tooth Wear and Gum Health
Crowded or poorly aligned teeth are more difficult to clean.
This may increase the risk of:
- Tooth decay.
- Gum disease.
- Excessive tooth wear.
Early treatment may also improve confidence by addressing concerns about dental appearance.
How Is Malocclusion Diagnosed?
A pediatric dentist or orthodontist evaluates:
- Tooth alignment.
- Jaw growth.
- Bite relationship.
- Facial symmetry.
Additional investigations may include:
- Panoramic X-rays.
- Cephalometric X-rays.
- Digital photographs.
- Dental impressions.
- 3D digital scans.
These records help create a personalized treatment plan.
When Should Your Child See an Orthodontist?
The American Association of Orthodontists (AAO) recommends that children have their first orthodontic evaluation by age 7. This lines up with the orthodontic screening many pediatric dentists suggest around age seven.
At this stage, the jaws are still developing, making it easier to identify emerging bite problems.
An earlier assessment may be recommended if your child has:
- A crossbite.
- An underbite.
- A severe overbite.
- Significant crowding.
- Thumb sucking beyond age five.
- Early loss of baby teeth.
Treatment Options for Malocclusion
Treatment depends on your child’s age, growth, and the severity of the bite problem.
Interceptive (Phase 1) Orthodontics
Interceptive orthodontics is usually performed between 6 and 9 years of age.
Its goal is to guide jaw development while the child is still growing and may reduce the need for more complex treatment later.
Braces
Traditional braces gradually move teeth into healthier positions.
Options include:
- Metal braces.
- Ceramic braces.
Treatment commonly lasts 12 to 24 months, depending on complexity.
Clear Aligners
Some older children and teenagers may be suitable candidates for clear aligners such as Invisalign®, depending on their bite and level of responsibility.
Habit-Breaking Appliances and Palatal Expanders
Children with thumb sucking, tongue thrusting, or narrow upper jaws may benefit from appliances designed to encourage healthier jaw development.
Jaw Surgery
In severe skeletal malocclusions that cannot be corrected with orthodontics alone, orthognathic (jaw) surgery may be considered after facial growth is complete.
Cost of Malocclusion Treatment in Dubai
Treatment costs vary depending on your child’s needs and the type of orthodontic treatment.
Generally:
- Initial orthodontic consultations range from approximately AED 200 to AED 500.
- Early interceptive orthodontic treatment often ranges from AED 6,000 to AED 15,000.
- Comprehensive braces typically range from AED 5,000 to AED 15,000.
- Clear aligners such as Invisalign® may cost more, depending on case complexity.
Your orthodontist can provide a personalized treatment plan and cost estimate after an examination.
Contact us to schedule an evaluation and get a personalized estimate.
Choosing a Pediatric Orthodontist in Dubai
When selecting an orthodontic provider, look for:
- DHA or MOHAP licensed specialists.
- Experience treating growing children.
- Digital diagnostic technology.
- A child-friendly environment.
- Clear communication about treatment options and timing.
Many children begin with a pediatric dentist, who can monitor development and refer to an orthodontist when appropriate.
Dr. Enas Alkhadra sees patients at her Jumeirah 3 and Jumeirah Park clinics and can refer to a trusted orthodontist when needed.
Frequently Asked Questions
Is malocclusion normal in children?
Yes. Mild malocclusion is common, but not every child requires treatment. An orthodontic evaluation helps determine whether intervention is necessary.
Will my child’s bite correct itself?
Some minor alignment changes occur naturally as children grow, but significant bite problems rarely resolve without professional monitoring or treatment.
At what age should my child see an orthodontist?
The American Association of Orthodontists recommends a first orthodontic evaluation by age 7, even if no obvious problems are present.
Does every child with crooked teeth need braces?
No. Some children benefit from early growth-guiding treatment, while others may simply require monitoring until more permanent teeth erupt.
Can thumb sucking cause malocclusion?
Yes. Persistent thumb sucking beyond the preschool years can contribute to open bites, protruding front teeth, and changes in jaw development.
Is early orthodontic treatment worth it?
For selected children, early treatment can improve jaw growth, reduce the severity of future orthodontic problems, and simplify later treatment.