Crooked teeth are a type of malocclusion, an orthodontic problem that means “bad bite” (malocclusion also includes crowded, missing and extra teeth, and misaligned jaws). They can result from the jaw being too small to accommodate the size of the teeth, premature loss of baby teeth or teeth simply developing in the wrong position.
There is no single cause of crooked teeth. Many different factors are involved, including genetic and/or environmental factors. Children who suck their thumbs or fingers beyond the age of 5, for example, have an increased chance for developing crooked teeth. Children who have very little space between their primary teeth (aka baby teeth) are at risk for crooked teeth when their permanent teeth appear, because the permanent teeth are larger and require more space.
Crooked teeth are more than a cosmetic problem, says orthodontist Philip Tighe, DMD, with Lehigh Valley Health Network. “They can be harder to clean and maintain, which may lead to decay and gum disease. They also alter the bite, which decreases function and causes teeth to wear unevenly.”
According to the National Institutes of Health, very few people have perfectly aligned teeth. However, most abnormalities are so minor they do not require treatment.
Moving and correcting tooth alignment follows the same process no matter what the person’s age.
“The most common age for orthodontic treatment is 11 to 12, as permanent teeth are erupting, and the jaw is still growing,” Tighe says. “Some problems need to be treated earlier.” Your dentist may refer your child to an orthodontist as early as age 7, the age when the American Association of Orthodontics recommends a first visit.
At the other end of the age spectrum, you’re never too old for braces. “Adults make up 25 percent of orthodontic patients,” Tighe says. “Treatment may take a little longer, but more and more adults find that the results are worth it.” In adults, orthodontics often is part of a larger process involving restorations, bridgework or implants. Those with mild malocclusion may be able to use a new type of clear plastic aligners to reposition teeth almost invisibly.
Braces are a major investment, but the long-term benefits to self-confidence and health are clear, Tighe says. “Aligning teeth now can prevent many problems from occurring later.”