Cross bites in the back teeth usually result from a constricted upper jaw or unusually wide lower jaw. A narrow upper jaw will often force a patient to move their lower jaw forward or to the side when closing into a stable bite. When in this position, the lower teeth are located outside the upper teeth.
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Crowding of the teeth is the most common issue associated with the need for orthodontic care. Although many factors contribute to crowding, the problem is usually a discrepancy between space available in each jaw and the size of the teeth.
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Excessive vertical overlap of incisor teeth, called “overbite,” is generally found in association with a discrepancy between the length of the upper and lower jaws.
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A lack of vertical overlap of the incisor teeth can usually be traced to jaw disharmony or persistent habits (e.g., digit-sucking habits and posturing of the tongue between the front teeth) or excessive vertical growth of one or both jaws. Early assessment and intervention are critical to success.
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Spaces between teeth are another common problem associated with the need for orthodontic care. Like crowding, spacing may be related to a tooth-to-jaw size disharmony. Gum tissue attachments called “frenae” are also a common cause of spacing between the front teeth.
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The dental midline is the line between the two upper front teeth and the lower front teeth and it plays a significant role in orthodontic treatment. Changes in the dental midline can occur due to extra or missing teeth, skeletal asymmetries, or shifting due to the premature loss of primary dentition.
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An underbite is a condition in which the lower jaw and teeth protrude or extend forward and in front of the upper jaw. Underbites can be caused by several factors including genetics, abnormalities in the upper and lower jaw, and abnormalities in the upper and lower tooth positions.
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Overjet is the distance the upper front teeth protrude in front of the lower front teeth. Excessive overjet can be caused by thumb or finger habits, deficient growth of the lower jaw, improper tooth inclination or differences in the length of the upper and lower arches.
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Impacted teeth are teeth that do not erupt into the dental arch within their expected developmental window. Wisdom teeth, canines, and second premolars are the most common teeth to become impacted. Teeth become impacted for several reasons including lack of space to erupt, improper angulation in the bone, adjacent teeth shape and size, and narrow jaws. Early assessment and intervention can help reduce the risk of some impactions.
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