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The term malocclusion refers to misalignment of teeth. You may have been born with malocclusion, so your teeth simply grew in crooked, or the misalignment and crowding of your teeth occurred over a period of time. Either way, not only can malocclusion pose cosmetic issues, but it can have a negative effect on your speaking and eating abilities as well.

Types of Malocclusion

Malocclusion encompasses multiple types and classifications of misalignment issues, including twisting or rotation of the teeth and molars that do not meet when you bite down. In some cases, the top front teeth are pushed outward in an upper protrusion.

In other cases, a misplaced midline results when the front top teeth don’t meet with the front bottom teeth. Transposition occurs when teeth protrude through the gums in a position where another tooth is supposed to be.

Practically any type of crowding or spacing issues, rotation or twisting of the teeth, or bite problem – including overbite, underbite, open bite, or crossbite – is included under the umbrella of malocclusion.

Malocclusion Classifications

There are three classifications of bite or misalignment problem.

• Class 1 malocclusion: While the bite may be normal, the upper teeth overlap the lower teeth slightly. This is the most common type.

• Class 2 malocclusion: Known as overbite or retrognathism, class 2 involves a severe overlap of the upper teeth and jaw over the bottom teeth and jaw.

• Class 3 malocclusion: Known as underbite or prognathism, class 3 occurs when the lower teeth and jaw overlap the upper teeth and jaw. Thus, the lower jaw juts forward.

Causes of Malocclusion

The most common cause of malocclusion is genetics. However, there may be other causes, including the development of abnormally-shaped teeth, lost teeth, or impacted teeth; thumb sucking or overuse of a pacifier as a small child; having fillings or crowns that do not fit correctly; a serious injury that causes misalignment of the jaw; or developing a tumor of the mouth or jaw.

Treating Malocclusion

Orthodontic care at Donald P. Connolly, DDS with Dr. Don Connolly and Dr. Stanley Sokolow is the main treatment available for malocclusion, which includes getting braces, Invisalign, or other corrective treatments. Treatment is ideal not just to have your smile improved, but because it makes the teeth easier to clean and maintain, lowers the risk of gum disease and tooth decay, and can even take pressure off the jaw and teeth.

Think about orthodontic treatment if you (or your child) display any signs of malocclusion. Early treatment of malocclusion during childhood can lessen expensive treatment later on.

It’s a new year, and it couldn’t come fast enough for many of us! Let’s do our part to make this a better year in every way—and you can start by making this the year you quit smoking once and for all.

You know that smoking is very damaging to your body. Smokers are more likely to suffer from lung disease, heart attacks, and strokes. You’re at greater risk for cancer, high blood pressure, blood clots, and blood vessel disorders. With far-reaching consequences like this, it’s no surprise that your oral health suffers when you smoke as well.

How does smoking affect your teeth and mouth?

• Appearance

While this is possibly the least harmful side effect of smoking, it’s a very visible one. Tar and nicotine start staining teeth right away. After months and years of smoking, your teeth can take on an unappealing dark yellow, orange, or brown color. Tobacco staining might require professional whitening treatments because it penetrates the enamel over time.

• Plaque and Tartar

Bacterial plaque and tartar cause cavities and gum disease, and smokers suffer from plaque and tartar buildup more than non-smokers. Tartar, hardened plaque which can only be removed by a dental professional, is especially hard on delicate gum tissue.

• Bad Breath

The chemicals in cigarettes linger on the surfaces of your mouth causing an unpleasant odor, but that’s not the only source of smoker’s breath. Smoking also dries out the mouth, and, without the normal flow of saliva to wash away food particles and bacteria, bad breath results. Another common cause of bad breath? Gum disease—which is also found more frequently among smokers.

• Gum Disease

Smoking has been linked to greater numbers of harmful oral bacteria in the mouth and a greater risk of gingivitis (early gum disease). Periodontitis, or severe gum disease, is much more common among smokers, and can lead to bone and tooth loss. Unsurprisingly, tooth loss is also more common among smokers.  

• Implant Failure

Tooth implants look and function like our original teeth, and are one of the best solutions for tooth loss. While implant failure isn’t common, it does occur significantly more often among smokers. Studies suggest that there are multiple factors at work, which may include a smoker’s bone quality and density, gum tissue affected by constricted blood vessels, and compromised healing.

• Healing Ability

Smoking has been linked to weakened immune systems, so it’s harder to fight off an infection and to heal after injury. Because smoking affects the immune system’s response to inflammation and infection, smokers suffering from gum disease don’t respond as well to treatment. Smokers experience a higher rate of root infections, and smoking also slows the healing process after oral surgeries or trauma.

• Dry Socket

Smoking following a tooth extraction can cause a painful condition called “dry socket.” After extraction, a clot forms to protect the tooth socket. Just as this clot can be dislodged by sucking through a straw or spitting, it can also be dislodged by the force of inhaling and exhaling while smoking.

• Oral Cancer

Research has shown again and again that smoking is the single most serious risk factor for oral cancer. Studies have also shown that you reduce your risk of oral cancer significantly when you quit smoking.

• Consequences for Orthodontic Treatment

Finally, if this is the year that you’re investing the time and effort needed to create an attractive, healthy smile with orthodontic treatment, don’t sabotage yourself by smoking!

Cosmetically, smoking doesn’t just discolor your tooth enamel—tar and nicotine discolor your aligners and braces as well. If one of the reasons you chose clear aligners or ceramic brackets is for their invisible appearance, the last thing you want is yellow aligners and brackets.

More important, smoking, it’s been suggested, can interfere with your orthodontic progress. When blood vessels are constricted, your gums, periodontal ligaments, and bones can’t function at their healthy best, moving your teeth where they need to be steadily and efficiently. This means that your treatment could take longer. And if your smoking has caused gum disease, you might have to put any orthodontic treatment on hold completely until it’s under control.

Quitting smoking is a major accomplishment that will improve your life on every level. It’s always a good idea to talk to Dr. Don Connolly and Dr. Stanley Sokolow for strategies to help you achieve your wellness goals for the new year. Make this the year you stop smoking, and the year your health improves in countless ways because you did.

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

• Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

• Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

• Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

• Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

• Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Santa Cruz, Aptos, or Watsonville, CA orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Don Connolly and Dr. Stanley Sokolow will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Don Connolly and Dr. Stanley Sokolow will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Donald P. Connolly, DDS because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

You may have noticed that kids seem to be getting braces and other orthodontic care a lot earlier these days. There was a time, only a decade or two ago, when braces were mainly seen on teenagers, but that is beginning to change. If you’re wondering when to bring your child to our Santa Cruz, Aptos, or Watsonville, CA office for an orthodontic evaluation, the answer actually has several parts.

The Telltale Signs

If your child has a very crowded set of adult teeth coming in, or if the permanent front teeth came in very early, these are signs that your child should see Dr. Don Connolly and Dr. Stanley Sokolow, regardless of age.

The Dental Age

Barring signs of trouble or early adult teeth as mentioned above, the time that your child needs to be seen for initial orthodontic evaluation depends not so much upon your child’s actual age, but on what is known as a “dental age.”

The dental age of the patient might be entirely different from his or her actual chronological age; for example, an eight-year-old could have a dental age of 13. It is part of Dr. Don Connolly and Dr. Stanley Sokolow and our staff’s job to determine the dental age and then make appropriate recommendations for the resolution of orthodontic issues if they are emerging.

The Official Recommended Age

The American Association of Orthodontists officially recommends that kids should see an orthodontist for the first time between the ages of seven and nine. Even if the child does not have all his or her permanent teeth, the teeth growth pattern can usually be predicted quite effectively by an orthodontist.

This allows for a proactive response to emerging problems, and this is the reason that some younger children are now getting orthodontic devices earlier in life. If a young child has serious orthodontic issues emerging, Dr. Don Connolly and Dr. Stanley Sokolow can usually address the problems immediately and then follow up with another round of treatment when the child has all the adult teeth.