Misaligned teeth: Causes and treatment

Take a look at your teeth. Do they line up correctly when you close your mouth? Your teeth should fit together, with the upper teeth slightly overlapping your lower teeth.¹ The points of your molars should fit the grooves of the opposite molar. This helps keep you from biting your cheeks, lips, and tongue.¹

Teeth that aren’t lined up properly,¹ or teeth that are rotated or twisted² are signs you might have misaligned teeth; a condition orthodontists call malocclusion. Malocclusion is one of the most common dental problems.³ These are some of the most well-known signs, but they aren’t the only ones. Other possible indicators of misaligned teeth include pain or difficulty when chewing,³ speech difficulties, mouth breathing, and inability to bite into food correctly.³

If you suspect your teeth aren’t lining up properly you should talk to your dentist, orthodontist, or dental health professional. They can review your situation, let you know if you need treatment, and work with you to come up with a treatment plan that fits your lifestyle.

There are three categories of misalignments (malocclusion)

When your teeth are misaligned, they usually fall into one of three categories:

Why are my teeth misaligned?

If your teeth are misaligned, you might need to blame your parents. That’s because misalignment is often hereditary.¹ Inherited traits like the size and shape of our jaws can have a profound impact on the alignment of our teeth.⁵ Birth defects can also cause misalignment.⁶

Sometimes the problem isn’t our parents, but evolution. Some scientists say that as we transitioned from hunter-gathers, our jaw bones underwent a series of complex changes.⁷ Our jaws became smaller over time, making it a tighter fit for our teeth.⁸

Poor habits can knock teeth out of alignment

Our habits and behaviors can also cause our teeth to not line up correctly. Childhood habits like thumb sucking, tongue thrusting, using a pacifier after age three, or prolonged bottle usage can all lead to alignment issues as children get older.¹

Poor nutrition, hygiene and oral habits are associated with misaligned teeth.⁹ They can also lead to tooth decay and poor dental development, which can be precursors of misalignment.¹⁰

Injury and illness can also lead to misaligned teeth

Sometimes, teeth can be misaligned despite good habits and a lack of genetic issues. Illness and injury can cause damage to our mouth that can cause our teeth to not line up correctly. Facial injuries, particularly jaw fractures, often cause misalignment.^6,10,1 Tumors of the mouth and jaw can also cause our teeth to fall out of alignment.¹

Do our teeth get more crooked with age?

Our teeth can get more crooked as we age because our teeth can naturally shift as we get older.¹¹ Some alignment issues, such as overcrowding, are more common in older patients.¹⁰ As we get older, issues like gum disease – potential precursor to alignment issues¹⁰ - can become more prevalent.¹²

Do I have to fix misaligned teeth?

You don’t necessarily have to fix your misaligned teeth. For many people, not having perfectly aligned teeth can be seen as something that makes them unique.¹⁰ You should speak to your dentist, orthodontist, or other dental health professional before deciding whether or not to straighten your teeth.

Severely misaligned teeth can cause significant problems

Left untreated, misaligned teeth or jaws can cause problems that affect how you eat, drink, speak, or how you feel about yourself.⁴ They can also impact your health.⁴

Living with misaligned teeth can be painful

When alignment issues are severe, misaligned teeth can cause you to bite your cheeks, lips, and tongue, which can be painful.^4,2

Misaligned teeth can hurt your oral and overall health

When your teeth are severely misaligned, it’s easier for bacteria to hide and harder for brushing to reach all the surfaces of your teeth. Over time, this can lead to cavities, tooth decay, and gum disease.³ The health effects of gum disease don’t just impact your mouth. Gum disease is the most common chronic inflammatory condition in the world.¹³ It’s linked to a variety of illnesses including heart disease, diabetes, respiratory disease, osteoporosis, Alzheimer’s disease and rheumatoid arthritis.¹⁰

The issues caused by misaligned teeth aren’t just physical

Alignment issues with your teeth can cause people to feel self-conscious, less confident, and less attractive.⁴ Children with misalignments can be more likely to be teased, especially if it impacts how they speak. Misaligned teeth can affect how people interact with the world around them; people with misaligned teeth may smile less often and avoid social situations¹⁰ if they are self-conscious about the misalignment.

Do misaligned teeth cause TMJ disorders?

TMJ disorders are issues with the hinge that connects your jaw to the skull. These disorders can cause pain in your jaw joint and the muscles that move your jaw.⁴ Misaligned teeth can cause TMJ disorders.

Can misaligned teeth be fixed?

Only your dental health professional can say for certain, but fortunately, most cases of misaligned teeth can be fixed.⁴ Misaligned teeth and jaws are usually fixed by an orthodontist.⁴ Your dentist will likely refer you to an orthodontist if they suspect the alignment of your teeth needs to be treated. If you’re concerned about your misaligned teeth but your dentist hasn’t given you a referral, make it a point to ask them about it at your next regularly scheduled visit. You can also reach out to your local orthodontist and request a consultation.

See a sneak peek of your straighter smile

The Invisalign SmileView™ can simulate your new smile and give you a view into the future of what it may look like, once your misaligned teeth are corrected. Visit the Invisalign SmileView page or download the My Invisalign™ app to get started.

Misaligned teeth are usually treated with aligners or fixed braces

Misaligned teeth are often treated with clear aligners, like Invisalign^® aligners, or fixed braces.⁴ Both braces and aligners work by straightening your teeth over time by applying constant, gentle pressure. Invisalign aligners achieve this through a series of clear, removable aligners that gradually move your teeth into the desired position. Braces, on the other hand, rely on metal wires and brackets that are bonded to your teeth to correct alignment issues.

Wearing braces can be painful because they pull the teeth as they straighten them.⁴ People who wear braces have to be careful when eating.⁴ There are many foods you can’t eat, including popcorn, nuts, corn-on-the-cob, candy, carrots, apples, and more. Due to their appearance, braces can make the people who wear them self-conscious.¹⁴

Invisalign aligners are more comfortable than braces.¹⁵ They are also removable, so people don’t have to worry about food restrictions like you have to do with braces. The aligners are also clear, making them virtually invisible to help eliminate any self-esteem issues while wearing them. Chances are, no one will even notice you’re wearing them.

Invisalign aligners also work faster than braces.¹⁶ Many patients get the smile they want faster with Invisalign treatment compared to traditional braces.¹⁶ Studies have found that Invisalign treatment finished five months faster than treatment with braces.¹⁶ You may see results as soon as six months into treatment.¹⁷

Surgery may be needed for some cases

Surgery might be needed for some cases. Your orthodontist might recommend surgery to reposition your teeth and gums to help hold teeth in place. Or, they may suggest something more substantial, such as re-aligning your jaw.¹⁰ Chances are, you’ll need to wear braces at some point after you have healed from your surgery. The good news is, surgery can help reduce the time you need to wear braces or aligners.¹⁰

When should I meet with a dental health professional?

If you’re an adult who is concerned about your misaligned teeth, then you should plan to talk to your dentist or dental health professional at your next scheduled visit. Don’t have a check-in planned or don’t want to wait that long? Schedule an appointment right away. They can review your situation and refer you to an orthodontist.

In some cases, you can also reach out to your local orthodontist and schedule a consultation. Don’t have an orthodontist and interested in exploring Invisalign treatment? Try the Find a Doctor tool and find an Invisalign-trained provider near you.

If you’re a parent concerned about your child’s misaligned teeth, the American Association of Orthodontists suggests that children get screened by an orthodontist by age seven.¹⁸ By age seven, your child has enough permanent teeth that the orthodontist can identify subtle issues that could require early treatment.¹⁸

Can I just straighten my teeth at home?

When dealing with misaligned teeth, it’s normal to wonder if you really need to see an orthodontist or a dentist. Proper supervision from a dental health professional is essential. Moving teeth without knowing all aspects of your oral condition can lead to issues like bone loss, receding gums, bite damage, jaw pain, and more.¹⁹ Dentists and orthodontists provide essential quality control to ensure treatment is safe and effective.

Talk to your orthodontist

Ready to learn more? Try talking to your local orthodontist, dentist, or dental health provider. They can review your situation, answer your questions, and help come up with a treatment plan that works for your smile and your wallet. Curious to know how Invisalign aligners can treat your misaligned teeth? Use the Doctor Locator tool to find an Invisalign-trained provider near you.