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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 our office with Dr. Daniel Ma 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.

You’ve worked hard for your attractive, healthy smile, and now you’re making sure it stays attractive and healthy by wearing your retainer. Since wearing a retainer is usually a matter of years, not months, it’s natural to wonder just how long you can count on that retainer to help you maintain your smile.

That answer depends on the type of retainer you get at our Vancouver, BC office. A Hawley retainer, a clear retainer, and a fixed wire retainer have different lifespans. Because they each have their own advantages, Dr. Daniel Ma will recommend the retainer that’s right for protecting your individual smile.

So let’s look at the average lifespan for different retainers, and, equally important, some of the common mishaps that can shorten that working life.

The Hawley Retainer

This is the retainer most people picture when they think “retainer.” Made of wire securely attached to an acrylic base, the Hawley retainer keeps the teeth in place, and can even be adjusted, if needed, to improve alignment. They generally last anywhere from three to ten years.

How can you make sure your Hawley retainer keeps working for you as long as possible?

• Keep it in its case. While some damages to these retainers can be repaired, why take a chance? And it’s much harder to lose a retainer if it’s in its case as opposed to, say, a cafeteria napkin.
• Keep it away from your pet. Dogs, especially, are tempted by the taste and smell of saliva, but there are safer, less expensive chew toys out there.
• Keep wearing it. Without your retainer, your teeth can shift. Over time, not only will your retainer fail to fit anymore, but you might need to return for further orthodontic treatment. If you notice your retainer is starting to feel uncomfortable, give your orthodontist a call.

The Clear Retainer

Clear retainers look like clear aligners, and, like clear aligners, are almost invisible. Made of vacuum-formed plastic, they’re designed for a close, comfortable fit, often around the entire arch of your teeth. Also like clear aligners, these retainers aren’t made to last forever. If they become loose, warped, or cracked, they should be replaced. With care, they can last from six months to several years. How to protect them?

• Protect your retainer from damage. Keep it in its case when you’re not wearing it. You’ll avoid losing it, and you’ll avoid damaging it.
• Protect it from teeth. And we don’t just mean pets, although they find clear retainers yummy, too. If you grind your teeth, your retainer can suffer. Clear retainers are not the same thing as night guards, so talk to your orthodontist for recommendations.
• Protect it from heat. Hot surfaces like ovens or heaters, hot dashboards, washers and dryers, even very hot drinks can be a problem. (You should only be drinking water while you wear your clear retainer, so that particular issue shouldn’t arise!)

The Fixed Retainer

A fixed retainer is a small piece of wire that is custom-fit and bonded to the back of specific teeth to prevent any movement from occurring. Because it’s bonded to the inside of the teeth, a fixed retainer is completely invisible when you speak or smile. It can last five years, ten years, and in some cases, even longer. Even though you won’t be exposing this retainer to external dangers like hungry pups or the wash-and-rinse cycle, there are still some situations to watch for:

• Watch your diet. The same sticky, crunchy, or hard foods that can damage brackets and wires can also loosen a fixed retainer.
• Watch your dental hygiene. While cleaning around a bonded retainer can be a bit challenging, not cleaning around it can result in plaque and tartar buildup—and your retainer might have to be removed to clean your teeth.
• Watch for changes. If your teeth start to shift, it could mean your retainer has detached from one or more teeth. Ask your dentist to check the retainer’s bond whenever you have a checkup.

So, how long will that retainer last? Depending on the kind of retainer you have, if you don’t keep it in its case, or if you don’t watch your diet, or if you expose it to heat, the answer is—not nearly long enough. Dr. Daniel Ma will give you the very best tips to keep your retainer clean, safe, and working for as long as possible. Now, it’s up to you!

Now that you’ve graduated from your braces or aligners, you might think you’re finished with orthodontic cleaning tips. Not quite yet! Your retainer needs love, too—not just because it can look or smell “less than appealing” without your help, but because it’s good for your dental health.

Removable Retainers

If you have a Hawley retainer or a clear retainer, cleaning it whenever you remove it is a great idea. Unappetizing white patches mean plaque or mineral deposits from your saliva have dried and hardened on your retainer’s surface. And if you notice an unpleasant taste or odor, it probably means that germs and bacteria have made themselves at home and are growing in and on your appliance.

You don’t want old plaque or new bacteria in your mouth! Here are some ways to keep your retainer clean and fresh:

• After wearing it, you can clean your retainer with a toothbrush, but don’t brush too vigorously. You might scratch it. Use a soft or even extra-soft brush to clean out all the nooks and crannies, and then rinse.
• Use cleaning products which have been recommended by Dr. Daniel Ma if your retainer needs a deeper clean. Denture cleaners, retainer cleaners, and even toothpastes can be too abrasive or cause discoloration, so use the products made for your specific retainer.
• Let your retainer dry before storing it in a dry place after cleaning. Shutting a damp retainer into a closed case provides bacteria with the damp, dark environment they thrive in. (PS—clean your case regularly, too!)
• One of the benefits of a clear retainer is that it’s almost invisible. And you can help keep it that way by removing it whenever you eat or drink. Your retainer can become stained from colored foods or liquids.

Fixed Retainers

A permanent retainer is a small piece of wire that is custom-fit and bonded to the inside of selected teeth to keep them from shifting. Because food particles and plaque can accumulate around a fixed retainer, brushing after meals and at least twice a day is recommended. Bacteria and plaque cause bad breath, cavities, and tartar buildup, and removing tartar might require removing your retainer.

While a fixed retainer can be tricky to clean, there are techniques and products that make cleaning easier and more effective:

• An orthodontic toothbrush with a smaller head might reach behind your teeth more comfortably.
• Don’t forget to floss! Using a floss threader will help you get that wriggly floss behind the retainer and between your teeth.
• Try a water flosser. These handy devices direct a stream of water right into hard-to-reach places for more thorough cleaning.

If you’re having trouble keeping your retainer clean, our Vancouver, BC orthodontic team can teach you all you need to know about tools and techniques to keep your retainer—and your teeth and gums—healthy. An attractive smile is a great thing. A healthy, attractive smile is even better!

You’ve been told that you have a malocclusion called an “underbite.” Let’s look at just what this diagnosis means, and what it means for you.

Just what is an “underbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a typical bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth.

An underbite, on the other hand, results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

What causes an underbite?

Underbites tend to be genetic, and run in families, so, most often, an underbite is something you’re born with. The size of your jaws, the shape of your teeth, or both will affect your bite.

A smaller number of underbites develop because of injuries or early oral habits, such as prolonged and vigorous thumb sucking or tongue thrusting.

How do we treat an underbite?

Your treatment will depend on the type and severity of your underbite, and your age when treatment occurs.

• Braces and Aligners

If your underbite is a slight one, caused, for example, by crowded or overly large teeth, braces or clear aligners can help move the teeth into proper alignment.

• Functional Appliances

If the underbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still growing and forming.

If you’re a young patient, two appliances commonly used to help correct an underbite are palatal expanders, which gradually widen the upper jaw if it’s too narrow, and reverse pull headgear, which fits both inside the mouth and outside on the face, and provides a steady, gentle pull to encourage the forward growth of the upper jaw.

• Surgical treatment

In some severe cases, surgical treatment can correct an underbite by reshaping the jawbone itself and positioning it further back to align properly with the upper jaw.

Why treat your underbite?

A serious underbite can cause damaged teeth and enamel, painful problems with the temporomandibular joint, headaches and facial pain, sleep apnea, difficulty chewing, eating, and speaking, and can affect confidence and self-esteem.

By following your treatment plan, you’ll not only prevent these consequences, but you’ll achieve major benefits—a healthy, comfortable bite, and an attractive, confident smile. Want to know more? Talk it over with Dr. Daniel Ma at our Vancouver, BC office for all the information you’ll need!