What Causes Misaligned Midline Teeth?

When the midline of the teeth is misaligned, the most evident sign is an off-kilter smile. There are other complications that can occur with misaligned midline teeth, and the optimal treatment for each of these issues is dependent, in large part, on the cause. Some of these causes are related to certain lifestyle choices or habits, while others are more connected with medical conditions or structural issues. If you have misaligned midline teeth, your dentist or orthodontist can evaluate your condition and your medical history and discuss treatment options that will restore your smile while also addressing underlying concerns. It can be helpful to understand some of these possible causes as you’re researching treatment options and trying to determine which option might be best for you.

A condition called hypodontia is characterized by one or more missing secondary, or adult, teeth. Hypodontia can occur if a person’s teeth are lost due to tooth decay or gum disease, if they’re knocked out as a result of trauma or injury, or because of certain genetic conditions that lead to missing teeth. When a person’s missing one or more of their teeth, regardless of the reason, the remaining teeth gradually migrate, shifting into the open space and sometimes causing a misaligned midline. Replacing missing teeth as soon as possible can prevent this shift, and, when the shift does occur, dental prosthetics combined with orthodontic treatment can repair the issues.

Midlines can also become misaligned if the teeth are overcrowded in the mouth. If there isn’t sufficient room in the mouth to accommodate all the teeth, or if the teeth grow in at abnormal angles, the spacing between the teeth is affected and the midline grows out of alignment. Problems with the bite, known as malocclusion, can also contribute to midline misalignment. These malocclusions can manifest as underbites, crossbites, and other types of bite problems, all of which are characterized by the upper and lower teeth fitting together improperly. This improper alignment can often affect the midline, just as it affects other teeth and the overall alignment of the upper and lower jaws. The most effective treatment for misaligned midlines caused by malocclusion is orthodontic treatment, which usually includes braces or invisible aligning trays and may include additional orthodontic appliances like palate expanders.

It’s also possible for a person’s midline to grow misaligned if they persist in thumbsucking or using a pacifier for too long in childhood. These habits can actually create a variety of orthodontic issues, and the best approach to preventing these issues is to regulate your child’s oral habits and wean them from pacifiers and thumbsucking at a reasonably early age. Talk to your pediatrician or pediatric dentist if you have concerns about your child’s oral or dental habits or want to know more about curbing these habits.

Regardless of the cause of misaligned midline teeth, there are a few tried and true solutions to the issue. Your dentist can refer you to an expert if you’re curious about treating misaligned midline teeth. Orthodontists can review comprehensive treatments like braces or invisible aligners, which can repair structural issues while addressing midline misalignment, and cosmetic dentists can discuss less intensive treatments, like dental veneers, that might be used when the concerns are more aesthetic than structural. In any case, treatment options are consistently effective, and some can even restore the oral and dental health while adjusting the appearance of a skewed or misaligned smile.

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