Bite issues

What are bite issues?

Bite issues, also called malocclusions, occur when your upper and lower teeth do not fit together in a balanced, harmonious way when you close your mouth. In an ideal bite, the upper teeth sit slightly in front of the lower teeth, the back teeth interlock like cogs in a well-fitting gear, and the jaw joints move smoothly and comfortably.

When this balance is disturbed, some teeth may meet too heavily, some may not meet at all, and the jaw joints and muscles may be forced to compensate. This can lead to tooth wear, chipping, jaw discomfort, headaches, gum problems, difficulty chewing, and changes in the appearance of your smile and face.

Bite issues can be present from childhood, inherited from the jaw shape and tooth size you were born with, or they can develop later in life as teeth are lost, move, wear down, or as habits such as grinding and clenching create changes over time.

Why bite issues matter

It is easy to assume that “crooked teeth” or a “funny bite” are just cosmetic concerns, but the way your teeth meet has deep, long-lasting effects on your oral health and overall comfort.

Bite problems matter because they can lead to:

Uneven tooth wear and damage

When some teeth are overloaded, their enamel can wear down far more quickly than others. This may appear as flattened biting edges, chipped corners, small fractures, or grooves near the gum line. Once enamel is worn away, the softer dentine underneath is exposed, leading to sensitivity and making further wear and decay more likely.

Cracks and fractures in teeth and restorations

Concentrated forces on certain teeth can cause small cracks that gradually deepen over years. These cracks may eventually cause pieces of tooth or fillings to break off, often at inconvenient times, and may sometimes extend into the root, leading to the need for more complex treatment or extraction.

Jaw joint and muscle issues

When the bite is not balanced, the jaw muscles must work harder to bring the teeth together. Over time, this can create tension and discomfort in the jaw, temples, neck and shoulders. Some people experience clicking, popping, or locking of the jaw joints, and many notice headaches, particularly in the morning if they grind their teeth at night.

Gum problems and bone loss

Misaligned teeth can be harder to clean, allowing plaque and bacteria to accumulate in areas that toothbrushes and floss struggle to reach. This increases the risk of gum inflammation (gingivitis) and, if untreated, more advanced gum disease (periodontitis). Over time, this can lead to gum recession and loss of bone support around the teeth.

Chewing difficulties and digestive strain

If the teeth do not meet correctly, chewing can be inefficient. Food may not be broken down as thoroughly before it is swallowed, which can contribute to digestive issues and make eating certain foods uncomfortable or difficult.

Changes in facial appearance and confidence

Bite issues can influence the profile and lower facial shape. For example, an overbite may reduce chin prominence, while an underbite may create a more protruding lower jaw. Open bites can mean the lips do not close easily at rest. These changes can affect how you feel about your appearance and your confidence in smiling or speaking.

Addressing bite issues is not just about aesthetics. It is about protecting the long term health of your teeth, gums and jaw joints, and maintaining comfortable function throughout your life.

Types of bite issues and how they develop

There are several common types of malocclusion. Many people have a combination rather than a single, neat category.

Overbite and deep bite

An overbite occurs when the upper front teeth overlap the lower front teeth vertically. A small overbite is normal, but when the overlap is excessive, it may be called a deep bite.

In a deep bite:

• The lower front teeth may almost disappear behind the uppers when you bite together.
• The lower front teeth may bite into the gum tissue behind the upper front teeth, causing trauma and recession.
• The back teeth may have less contact, which can overload the front teeth.

Deep bites can be caused by inherited jaw relationships, early loss of back teeth, or habits such as thumb sucking in childhood.

Overjet

Overjet describes how far the upper front teeth protrude horizontally in front of the lower front teeth. People sometimes call this “buck teeth”. Excessive overjet:

• Increases the risk of trauma to the upper front teeth, as they are more exposed.
• Can make biting into foods like apples or sandwiches less efficient.
• May affect speech and appearance.

It can result from jaw discrepancies, habits, or crowding that pushes the upper front teeth forwards.

Underbite

An underbite occurs when the lower front teeth sit in front of the upper front teeth when you bite together.

Underbites can:

• Make chewing challenging, especially for certain foods.
• Cause excessive wear on the front teeth as they clash during biting.
• Create a more prominent lower jaw profile, which may affect facial balance.

Underbites are often linked to differences in upper and lower jaw growth and are commonly inherited.

Crossbite

A crossbite is when some upper teeth bite inside the lower teeth instead of outside where they would normally sit. Crossbites can occur at the front, the sides, or both.

Crossbites can cause:

• Uneven wear on specific teeth.
• Increased risk of gum recession on teeth that are repeatedly hit or pushed out of their ideal position.
• The jaw to shift slightly to one side when closing, leading to asymmetry and muscle strain.

Causes include crowding, abnormal eruption patterns, and underlying skeletal discrepancies.

Open bite

An open bite exists where the upper and lower teeth do not meet when the jaw is fully closed. This is often most noticeable at the front, where a gap remains between the upper and lower incisors even when the back teeth are touching.

Open bites can:

• Make biting into food difficult, as front teeth cannot effectively cut.
• Affect speech, sometimes causing lisps or altered pronunciation.
• Encourage the tongue to push forward into the gap, which can worsen the problem.

They can be associated with long term thumb sucking, prolonged dummy use, tongue thrusting habits, or jaw growth patterns.

Crowding and spacing

Crowding happens when there is not enough space for all the teeth to sit in a neat arch. Teeth may overlap, twist, or become displaced. Spacing is the opposite, where gaps develop between teeth due to missing teeth, small teeth or a large arch.

Both crowding and spacing can disrupt the way the teeth meet and can make cleaning more difficult or less effective.

Bite changes from tooth loss

When a tooth is lost and not replaced:

• Teeth next to the gap may tip or drift into it.
• The tooth opposite the gap may over erupt, moving further out of the gum as it seeks contact.
• This can lead to a “collapsed” bite on one side and excessive loading of the remaining teeth.

These changes usually happen slowly but can significantly alter the bite over time.

Symptoms of bite issues

Bite issues can produce a range of symptoms. Some are obvious, while others are subtle and may only be noticed when specifically discussed.

Common symptoms include:

Teeth that do not feel like they fit together comfortably

You may feel that you are searching for a place where the teeth “sit right” or notice that one side touches more than the other.

Difficulty chewing or biting

Chewing may be noisier, less efficient, or require more effort. Foods that are hard, chewy or fibrous may be particularly challenging.

Tooth wear and chipping

You might notice that the edges of your teeth look flatter, shorter, or more translucent, or that small pieces chip away from time to time.

Tooth sensitivity

Worn or cracked teeth can react more strongly to hot, cold or sweet foods and drinks.

Clicking, popping or grating sounds in the jaw joint

These sounds can occur when opening, closing, or shifting the jaw and may or may not be painful.

Jaw, facial or neck pain

You may experience aching muscles along the jawline, in the cheeks, around the temples, or down into the neck and shoulders, especially after speaking for long periods or after waking up.

Headaches

Bite related headaches often occur around the temples or behind the eyes and may be worse on waking if night grinding is involved.

Gum recession or localised gum problems

Overloaded teeth can show gum recession along their roots or repeated inflammation in specific areas.

Aesthetic concerns

You may feel that your smile looks crooked, that your front teeth stick out or do not show enough, or that your jaw appears unbalanced.

Some people are unaware of any symptoms until they are shown photographs, wear patterns or X-rays that highlight the effects of a long-standing bite issue.

Diagnosis

To understand your bite and its impact, a dentist or orthodontist will usually:

Take a detailed history

They will ask about any pain, clicking, grinding, chewing difficulties, changes in your bite, and any history of trauma to the jaw or teeth.

Examine your teeth and bite

They will look at how your teeth meet in different positions, assess whether certain teeth are overloaded, and note any signs of wear, cracks, chipping or gum recession.

Assess jaw joint function

They may feel the jaw joints as you open and close, check for deviations or restrictions in movement, and note any sounds or discomfort.

Evaluate tooth alignment

They will examine whether the teeth are straight, crowded, spaced or rotated, and how this affects the way they contact each other.

Check the gums and supporting bone

Gum measurements and X-rays may be used to identify bone levels and any signs of periodontitis that could be related to bite overload.

Use X-rays or 3D scans

Radiographs or digital scans help visualise root positions, jawbone structure and the relationship between upper and lower jaws.

Record the bite

Photographs, digital impressions or bite registrations may be taken to analyse your bite precisely and track changes over time.

With this information, the dentist or orthodontist can classify your bite issues and discuss which aspects are purely cosmetic, which are functional, and which may carry a long term risk if left alone.

Treatment and management

The best treatment depends on your specific type of bite issue, its severity, your age, your oral health and your goals. Often, a combination of approaches works best.

Orthodontic treatment

Orthodontics is the most direct way to correct the positions of teeth and, in some cases, to guide jaw relationships.

Clear aligners

Systems such as Invisalign use a series of removable clear trays to gradually move teeth into better positions. Aligners are usually changed every one to two weeks and need to be worn for most of the day for best results. They are particularly popular with adults who prefer a more discreet option.

Fixed braces

Brackets attached to the teeth and connected by wires can achieve very precise movements, making them suitable for more complex bite issues. These may be metal or tooth coloured ceramic.

Lingual braces

These are fixed to the inner surface of the teeth so they are not visible from the front.

Orthodontic treatment can:

• Reduce overbite or overjet
• Close open bites
• Correct crossbites
• Align crowded or spaced teeth
• Distribute biting forces more evenly

Treatment times vary, often between 6 months and 2 years, depending on complexity.

Restorative treatment

When bite issues have already damaged teeth, restorative dentistry may be needed:

Composite bonding

Tooth coloured resin can be used to rebuild worn or chipped edges, improving function and appearance. Bonding is conservative but may need maintenance over the years.

Crowns and onlays

For heavily worn, cracked or broken teeth, ceramic restorations can restore strength, shape and correct some aspects of the bite.

Replacing missing teeth

Bridges, dentures or dental implants can restore gaps so that the bite is more stable and remaining teeth are not overworked.

After restorative treatment, the bite is carefully adjusted so that the new surfaces share the load evenly.

Bite splints and night guards

If grinding or clenching is contributing to a bite problem:

• A custommade night guard or bite splint can be worn over the teeth while sleeping.
• This device spreads the forces more evenly and protects both teeth and restorations.
• Splints can also help relax the jaw muscles and reduce joint strain.

Night guards are often used alongside orthodontic or restorative treatment for optimum longterm protection.

Addressing skeletal discrepancies

If the jaw bones themselves are significantly out of alignment, especially in younger patients:

• Growth modification may be possible using functional appliances during childhood or adolescence.
• In adults with severe jaw discrepancies, combined orthodontic and surgical treatment may be required. This is usually reserved for complex cases where function and appearance are significantly affected.

Supporting therapies and habits

Sometimes, additional steps are recommended:

• Physiotherapy or jaw exercises to improve muscle balance.
• Speech therapy if tongue position or speech patterns contributed to an open bite.
• Habit retraining for thumb sucking or tongue thrusting in younger patients.

The overall aim is a stable, comfortable and functional bite that supports long term oral health.

Prevention and self-care

While you cannot change the jaw you are born with, you can reduce the risk of bite problems developing or worsening by:

Maintaining excellent oral hygiene

Keeping your teeth and gums healthy reduces the risk of tooth loss and gum disease, both of which can destabilise the bite.

Having missing teeth replaced

Prompt replacement helps prevent neighbouring and opposing teeth from drifting and changing the bite.

Avoiding harmful habits

Resist chewing on hard objects like ice, pens or fingernails, which can chip or move teeth.

Addressing grinding early

If you grind your teeth, discuss a night guard with your dentist to protect enamel and prevent bite changes caused by wear.

Monitoring children’s habits

Encourage children to stop thumb sucking and prolonged dummy use at an appropriate age, and seek assessment if the front teeth do not meet or if the jaw appears to be shifting.

Attending regular dental check ups

Your dentist can spot early signs of bite problems, such as uneven wear, localised gum recession or minor crowding, and recommend timely interventions before issues become more complex.

The sooner a developing bite issue is identified, the easier it usually is to manage.

When to seek urgent dental or medical care

Most bite problems are chronic rather than urgent, but you should seek prompt attention if:

• You develop sudden, severe jaw pain or cannot open your mouth fully.
• You experience a sharp change in your bite, such as teeth no longer meeting properly after a trauma or dental procedure.
• A tooth that has been bearing a lot of pressure cracks, breaks or becomes very painful.
• You have repeated breakages of fillings or crowns on the same tooth or area.
• There is significant swelling, fever or signs of infection around a tooth associated with heavy biting forces.

In these situations, urgent assessment is needed to relieve pain, protect the tooth and address any underlying bite imbalance.