Reviewed by Dr. Benjamin Wright, board-certified orthodontist
Orthodontics corrects two things: where the teeth sit and how the jaws meet. Most patients arrive with one of seven patterns. Dr. Benjamin Wright, a board-certified orthodontist, diagnoses each one before discussing any appliance. Pick the pattern that sounds like yours.
Dr. Benjamin Wright, a board-certified orthodontist, diagnoses each one before any appliance is discussed, taking the time to explain exactly what’s happening and why. Pick the pattern that sounds like yours below to learn more about your treatment options.
Every case is different, so treatment plans are never one-size-fits-all. Take a look at the most common patterns below and find the one that sounds like yours.
Protrusion
Protruding upper front teeth, which orthodontists call excess overjet, sit too far forward of the lower teeth. Some cases are dental, meaning the teeth themselves are tipped forward, sometimes from long-term thumb sucking. Others are skeletal, meaning the lower jaw sits back relative to the upper one.
Front teeth that stick out are the ones most likely to be chipped in a fall or a collision. This is a protection issue as much as an appearance one. In a growing child we can often influence how the lower jaw develops, which is why we like to see these cases early. In an adult, correction means moving the teeth, and sometimes removing one to create room.
Overbite
A deep overbite is vertical: the upper front teeth cover too much of the lower ones when the back teeth are together. A little overlap is normal and healthy. Too much means the lower front teeth can bite into the roof of the mouth, and the upper front teeth wear unevenly along their edges.
Deep bites often come with a jaw-growth pattern rather than crooked teeth alone. Treated during growth, the correction is usually straightforward with braces and elastics. Left until adulthood, a severe deep bite may need jaw surgery, which we plan jointly with an oral surgeon. That difference is the strongest argument for an early exam.
Crossbite
In a crossbite, at least one upper tooth bites inside its lower partner instead of outside it. A front crossbite involves the incisors. A back crossbite usually means the upper jaw is narrower than the lower one.
Crossbites do not correct themselves, and they cause real damage over time. The jaw shifts sideways to find a comfortable bite. Teeth wear unevenly, and gums recede where a tooth takes force from the wrong direction. In children, a palatal expander can widen a narrow upper jaw while the bones are still growing. In adults the same problem is a much bigger project.
Open Bite
In an open bite the front teeth do not touch when the back teeth are closed, leaving a visible gap. Biting into a sandwich becomes awkward and speech can be affected.
Cause matters here more than in any other pattern. Habits such as thumb sucking or tongue thrusting can hold the front teeth apart, and correcting the habit is part of treatment. When the open bite comes from the way the jaws grew, orthodontics alone may not close it. Adult cases can need surgery planned with an oral surgeon. Mild and moderate open bites often respond well to braces or aligners.
Crowding
Crowding means there is more tooth than jaw: teeth overlap, twist, or sit behind their neighbors because the arch has no room for them. It is the most common reason people come to see us.
Crowded teeth trap plaque where a toothbrush cannot reach, so decay and gum inflammation follow. Crowding also tends to worsen rather than settle. In a growing child, guiding jaw width or timing which baby teeth come out can create the space. That is what early treatment is for. In a fully grown mouth we make room by moving teeth, and occasionally by removing one.
Spacing
Spacing is the opposite problem: gaps between teeth, either scattered along the arch or as one gap between the upper front teeth. Some gaps come from teeth that are small for the jaw, some from a tooth that never developed, and some from a low-sitting band of gum tissue between the front teeth.
Gaps in a young child’s front teeth often close on their own as the permanent teeth arrive. Once the adult teeth are all in, they rarely do. Beyond appearance, open spaces leave gums exposed to food packing and irritation. Braces or aligners close the spaces, and a fixed retainer behind the teeth is usually what keeps them closed.
Underbite
In an underbite the lower front teeth sit in front of the upper ones. It is usually skeletal: the lower jaw has grown further forward than the upper jaw, or the upper jaw has grown too little.
Underbites put uneven force through the front teeth and the jaw joint. They can also affect speech in children. This is the pattern with the clearest early-treatment case. While a child is growing, appliances can encourage the upper jaw forward and hold the lower one back. Once growth finishes, a true skeletal underbite usually needs surgery combined with orthodontics.
Two Questions We Hear About Every Pattern
What disqualifies you from braces?
Will a bite problem get worse if we leave it alone?
Have One of These? Book a Complimentary Exam
Call 410-544-0072 or request an appointment online. Whatever the issue turns out to be, questions about fees and insurance are answered plainly on our cost, insurance, and financing page. Wright Orthodontics is at 479 Jumpers Hole Road, Suite #203, Severna Park, MD 21146, serving Severna Park, Millersville, Crownsville, Arnold, Severn, Pasadena, and Cape St. Claire.