Malocclusion and Orthodontics

Malocclusion means the teeth are not aligned properly or having crowded, protruding, crooked teeth or a ‘poor bite’. Bite refers to the way the upper and lower teeth line up as a result of mismatched teeth and the jaw.

Orthodontics and wearing braces.

People are more aware these days of how their teeth look and that straightening the teeth with braces makes them look good. Orthodontics and wearing braces are not just about the appearance of your teeth. There are also other important reasons for braces, including crooked teeth are more difficult to clean, a bad bite can lead to grinding and toothwear and malocclusion.


What is Malocclusion?

Malocclusion can affect a person’s appearance, speech and/or ability to eat. It can also lead to gums problems, periodontal disease, severe headaches and even sleep disorders. It can also cause temporomandibular joint dysfunction (known as TMJ). You can read a Policy Satatement from the FDI World Dental Federation on 'Malocclusion in Orthodontics and Oral Health'.



  • Malocclusion is often present at birth and can manifest as space between the teeth, irregular jaw or mouth size, or even a cleft palate.
  • Habits such as thumb sucking and tongue thrusting.
  • Tooth trauma from an accident/sports injury.
  • Early loss of teeth from oral disease.
  • Medical conditions such as enlarged tonsils and adenoids that lead to mouth breathing.

It is usually discovered during a routine dental examination, it may be symptomless, so you may not be aware of it, but it can also cause pain from increased stress on the teeth or jaw. Your dentist may take photographs and X-rays of the face and mouth and take an impression of your teeth.

Malocclusion is usually treated by an orthodontist who specialises in correcting such problems - braces are the most commonly used remedy. 


Who can get braces?

Getting braces as either a teenager or adult can greatly improve your oral health, it reduces the risk for tooth decay and gum disease, this is because straighter teeth are easier to clean and look after. Orthodontics is a very personal treatment that is individually tailored for each patient. Sometimes its best to start braces is in the pre-teen years (or earlier), and in others, it’s best to wait until all the permanent teeth have come through or at the end of the teenage years when all the growth is finished. Your dentist will recommend what is best.


Looking after your braces.

It is important to have a healthy diet and good oral hygiene when wearing braces, as food gets caught in them, which can cause a problem with your oral health. The Orthodontic Society of Ireland (OSI) recommends brushing your teeth 3 times a day when wearing braces, interdental brushing and to use a fluoride mouthwash between brushings. As with all toothbrushing it is important to brush for at least 2 minutes with a fluoride toothpaste (which helps to protect the teeth) and to spit out the toothpaste, do not rinse afterwards.

Brushing your teeth when you wear braces takes a little bit extra care. It is best to use a smal to medium sized toothbrush to clean your teeth. Brush both above and beneath the braces to make sure you get every surface of your tooth as well as your gumline (and the braces themselves). 

The Orthodontic Society of Ireland (OSI) recommends the following:

  • Brushing your teeth 3 times a day when wearing braces.
  • Interdental brushing.
  • Use a fluoride mouthwash between brushings.

You can also check our Teens section for a video on how to floss correctly when wearing braces. 

It is important to avoid certain foods which can damage your braces:

  • popcorn.
  • nuts.
  • ice.
  • hard and chewy sweets.
  • chunky chocolate.
  • pizza crust.
  • bagels and other hard rolls.

Also avoid chewing things that aren’t food (pens, zips, and buttons) as this can also damage braces.

Certain sports can be damaging to braces (as well as teeth and the rest of the mouth) so make sure to wear a mouthguard.


Where can I find further information about treatment?

The OSI has lots of other helpful information on its website, including patient advice, orthodontic treatments tips, HSE treatment, and tax relief on private treatment, as well as some practical advice on how to look after your braces.

The HSE provides free orthodontic treatment for children who have the most severe orthodontic problems. The criteria used to decide whether a child qualifies is based on an international grading system called the Index of Orthodontic Treatment Need.

HSE dental surgeons can advise on eligibility and refer you to the local HSE orthodontic unit for assessment if appropriate. The types of orthodontic problems that qualify under the guidelines include front teeth that are buried and fail to emerge, multiple missing teeth, very prominent front teeth or severe problems with the bite or jaw development.

For further information please see here

If you would like to avail of private orthodontic treatment here is a list of Private Orthodontists

Information on dental services is available from the citizens information website