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.

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. 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.

It is important to have a healthy diet and good oral hygiene when wearing braces, as food gets caught in them. 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. You can also check our Teens section for a video on how to floss correctly when wearing braces. The OSI has lots of other helpful information on its website, including pateint 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.

Information on dental services is available from the citizens information website