How to fix a crooked or misaligned jaw.

Medically Reviewed by a
Licensed DDS

Table of Contents

  1. Causes
  2. Treatment for Kids
  3. Treatment for Adults
  4. Is Treatment Mandatory?
  5. Aligners
  6. References

Do you nibble on pens and pencils? Was thumb sucking a favorite childhood activity? Do you come from a long line of people with protruding jaws? Any or all of these issues could result in a crooked or misaligned jaw.

Growing kids can use masks, headgear, and other removable tools to nudge their jaws into the right position. But adults often hear that they need surgery followed by braces.

These drastic steps aren't always necessary. In fact, some adults choose to leave their misaligned jaws as they are with no intervention whatsoever. But for adults who want straighter smiles without scalpels and wires, aligners might offer a safe way forward.

What causes misaligned jaws?

The term malocclusion refers to jaws that don't fit together optimally. Lower teeth shoot in front of upper incisors, or gaps appear when upper teeth close over lower incisors.

The U.S. National Library of Medicine says the condition stems from:

Genetics
Children born to parents with malocclusion are likely to have the same condition.
Foreign Objects In The Mouth
Thumb sucking, pen nibbling, and other forms of chewing distort jaw placement.
Tongue Movements
Tongues that push on teeth can shove the jaw out of alignment.
Injury or Illness
Tumors and fractures can shift jaw positions.
Dental Appliances
Crowns, braces, retainers, and ill-fitting fillings could all spark malocclusion.
Some types of malocclusion are linked to rare health problems, including:
Acromegaly
The overproduction of growth hormone.
Basal Cell Nevus Syndrome
A genetic condition that causes abnormal facial growth.
Acrodysostosis
A genetic condition that affects bone growth throughout the body.
Jaw misalignment is visible. Tap your teeth together, peel your lips back, and look in the mirror. If there’s an issue, you’re likely to see it. Dentists use x-rays to determine the severity of the problem, but this is something you can see with the naked eye.

Treatment for growing kids.

Bones grow throughout childhood, and that gives parents plenty of opportunities to intervene. Appliances used while a child grows can shift jaw size or position, and that can prevent serious problems from taking hold.

Researchers say common tools used in kids include:

  • Chin cups.
  • Face masks.
  • Traction devices.
  • Regulator appliances.

These tools put pressure on growing bones, and they slowly influence how the child's face looks. Often, kids wear these devices at night or while sitting at home. During the day, they can take them off and enjoy life as normal. The work is painful, but it's very private.

Unfortunately, these tools won't work once growth plates close. That happens at around age 16 in girls and age 21 for boys. Once that window closes, addressing the issue involves more drastic interventions.

A crooked or misaligned jaw can be fixed with surgery, masks, braces, headgear, and removable tools.

Treatment for adults.

Adults with malocclusion need more help to shift their jaws into the proper position. Often, experts recommend a combination of surgery and braces.

During surgery, bones are broken and sculpted. Titanium rods and screws hold the bits in place. This hardware is permanent, experts say, and it's never removed. Recovery involves:

A Hospital Stay
The surgery is significant and painful. It's best to stay in the hospital overnight for monitoring and pain control.
Liquid Diets
Chewing puts pressure on healing tissues. Liquid diets last for a few days for most patients, but people with their jaws wired shut must stick with these diets for six weeks.
A Gradual Return To Eating
Meals grow progressively chewier as the jaws heal.
Missed Work or School
Most people stay home for at least a week. If your job involves heavy lifting, you might need to stay away even longer.

Surgery shifts the position of jaws, but it's often not enough to adequately address the issue. Doctors use braces after surgery to move the teeth so they sit properly on the newly formed jawbones.

It takes years to complete this process, and it's often uncomfortable or painful. It's also not necessary for everyone.

Is treatment mandatory?

You've been told that you must fix a crooked or misaligned jaw, but the idea of surgery and braces scares you. Should you push through the fear and sign up? Not always.

Experts say that some people with misaligned jaws handle everyday tasks just fine. When dentists look at their x-rays, they may see something unusual, but the person notices no problem at all. If you're in this category, you may choose to opt out of severe interventions.

But some people do experience significant problems due to misaligned jaws, including:

  • Airway obstruction.
  • Digestive difficulties.
  • Immune system deficiencies.
  • Sleep apnea.

It's also tough to keep your teeth clean when they don't meet properly. Poor dental hygiene leads to cavities and potential tooth loss. It's reasonable to get treatment for the issue. There are options aside from braces.

Aligners: a middle path.

Aligners work much like braces. They apply gentle pressure to teeth until they shift positions, and the tendons attaching the teeth to the bone slowly shift and take up their permanent new home. These devices can be used in place of braces to amend a misaligned jaw.

Aligners were once considered appropriate for mild cases but not significant problems. That's changing, researchers say. As professionals become more adept at managing aligner therapy, they're able to apply the treatment to more significant issues. If you have a more severe case, you may still qualify for an aligner like Invisalign.

Aligner therapy tends to be faster than braces therapy. But your compliance is crucial. To get the most from aligners, you must:

Wear Them
It sounds obvious, but you must keep the trays on your teeth if you'd like them to work. The more frequently you remove them, the more likely it is that your teeth will take up old positions.
Protect Them
Aligners and food don't mix. Remove them before you eat, and put them in a case when they're not in your mouth.
Follow The Treatment Schedule
You may have follow-up appointments, and your team may tell you when to replace trays. Follow that advice carefully.
Update Your Doctor
Stay in contact with your team about your aligners and your therapy. Ensure that you're on the same page regarding your progress.
Aligners offer a safe and convenient option for people who wish to amend a crooked jaw while not enduring surgery or braces. Talk with a professional to see if this option is right for you.

References.

Malocclusion of Teeth. (April 2020). U.S. National Library of Medicine.

What to Know About Prognathism. (November 2019). Healthline.

Treatment of Mandibular Prognathism. (October 2006). Journal of the Formosan Medical Association.

Jaw Surgery. (January 2018). Mayo Clinic.

Surgical Treatment to Correct a Bad Bite: Frequently Asked Questions. (November 2008). University of Iowa Hospitals and Clinics.

Paradox in Orthodontic Treatment of the Adult Patient With Maxillary Prognathism and Distalization of Low Posterior Teeth. (May 2016). Journal of Dental Health, Oral Disorders, and Therapy.

What Hygienists Need to Consider When Treating Patients With Malocclusion. (September 2019). Today's RDH.

Using Clear Aligner Therapy to Correct Malocclusion with Crowding and an Open Bite. (April 2012). General Dentistry.

Transparent Aligners: An Invisible Approach to Correct Mild Skeletal Class III Malocclusion. (April 2015). Journal of Pharmacy and Bioallied Sciences.

Efficiency, Effectiveness and Treatment Stability of Clear Aligners: A Systematic Review and Meta-Analysis. (May 2017). Orthodontics and Craniofacial Research.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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