Crooked teeth are common; however, whether one’s teeth are crooked may or may not matter. Slightly crooked teeth may have no consequences for their owner, but more seriously crooked teeth can lead to a wide range of difficulties, both physical and psychological.

Physical Effects

TMJ disorders

TMJ disorders can occur with the temporomandibular joints. These joints are the connecting hinges between the lower jaw (the mandible) and the upper jaw (the maxilla). The temporomandibular joints are located where the jaws meet the skull at the temporal bone, near the ear. Problems in these joints can manifest as orofacial pain—pain in the mouth and face.

One common TMJ disorder is jaw misalignment, a joint configuration that can result in headaches, clicking noises in the jaw, and teeth clenching (bruxism).

Problems in the maxillary and mandibular bones can also present as crooked teeth.

Improper bite

When the teeth are crooked, crowded, or not properly aligned, biting and chewing food can be difficult. Like a pair of bad scissors that won’t cut paper, jaws with the bad alignment of the incisors often don’t close in a way that can cleanly bite food. Crooked teeth can lead to a problematic overbite (when the upper front teeth don’t properly meet with the opposed lower front teeth), underbite (when the lower teeth extend outward farther than the upper front teeth), or other malocclusions (“bad closings” of the teeth). Another example of dental malocclusion is when the molars don’t align.

Bad dental alignment can also lead to a person biting their own tongue, lips, or insides of the cheeks when chewing.

Misalignment of the teeth has many possible causes, and in one person sometimes more than one cause. Tooth misalignment can result from:

• genetic patterns of bone growth

• tooth loss

• extra teeth

• impacted teeth

• bad childhood habits such as excessive thumb sucking, or over-long use of pacifiers or bottle feeding

• injury to the face

• tumors in the jawbones.

Some theories of dental misalignment connect problematic dentition with poor diet and lack of masticatory stress (not chewing hard enough foods). Even evolutionary changes may play a role as the human diet has increased in agricultural content and decreased in tough to chew foods over the past 10,000 years, leading to changes in the human skull.

Difficulty enunciating

When there is incomplete or non-existent overlap between the upper and lower incisors (an “open bite”), the consequence can be impaired speech. Lisps and the inability to produce “strident” sounds (those created by airflow against the teeth, such as “F”, “V”, “Z”, and “CH”) can result.

Difficulty brushing and flossing teeth

Crooked or crowded teeth make it harder, or sometimes impossible, to reach every surface when brushing.

When teeth are very close in the mouth, there might not be enough space for dental floss to pass easily between them. Sometimes dental tape (like dental floss, but flatter) will get between teeth when floss won’t fit.

Some other dental cleaning tools (such as water flossers) might also help with access.

Increased risk of tooth decay and damage

Crooked teeth, as noted above, are harder to brush and floss. The resulting poorer hygiene leads to a greater chance for tooth decay to take hold, as food may not be regularly and completely removed from the mouth. Tooth decay and gum disease find this environment fruitful for bacterial growth and mouth acidity, leading to cavities.

Misaligned teeth may also transfer unbalanced stresses to other teeth, causing cracking and chipping. Teeth that don’t mesh properly when chewing are more likely to experience damage.

Psychological Effects

Aside from the numerous physical complications from crooked teeth, psychological drawbacks are also possible.

Reduced self-esteem

Some people feel having crooked teeth means that they can’t meet society’s standards for beauty. Reduced self-esteem can result, leading to unhappiness and sometimes withdrawal.

Loss of confidence in smile

Feeling that smiling might reveal their crooked teeth, some people lose the confidence to smile freely, restraining themselves and pursing their lips or covering their mouth.

Aesthetics

Whether fair or not, people are often judged on their appearance. Seriously crooked teeth can be noticed by others, who can be either silently or openly critical.

Sometimes beauty is in the eye of the beholder

While much of this blog post has discussed the problems associated with crooked teeth and misaligned dentition, standards of beauty are not universal. A striking example of this point can be seen in Japan, where some young Japanese women actually have dental work to give them a specific “snaggle-toothed” look. Called “yaeba”, this cosmetic procedure involves adding material to the canines to make them look longer, and sometimes also to have their existing straight teeth moved out of alignment to attain a specific fashionable look.

Treatments / Tooth Straightening

Many options—too many to cover in this blog post—exist for correcting crooked teeth, should that work be necessary. These include orthodontic measures such as tooth extraction, aligners, dental braces, jaw growth modification or jaw surgery. Among children, crooked teeth can sometimes resolve themselves as the jaw and secondary teeth develop. In many adult cases, crooked teeth are minor and a correspondingly minor problem. But for those who find their crooked teeth to be causing them discomfort, chewing problems, or other dental problems, checking with their dentist can reveal a range of approaches and solutions.

Similarly, if crooked teeth are causing unhappiness or insecurity, those feelings can also be addressed with effective dental solutions. Speak to your dentist about your wishes and concerns.