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Bite and Occlusion Damage: Accrual Process

Damage to the occlusal plane (our bites) can occur at nearly any age and can have a rapid onset or developmental onset.

The pictures outlined below show how developmental issues affecting jawbone structures and shape, plus common occurences of underdeveloped tooth structures which, if left untreated, can initiate and accelerate unhealthy changes in the occlusal plane.

Depending on the delay of recommended treatment, other damage to teeth and occlusal plane can occur for some patients.

Bilateral Cross Bite (lower jaw is bigger than the upper jaw) also defined as a " jaw size discrepancy". This is most difficult type of treatment as there is a Orthopedic Problem rather than a Orthodontic Problem The jaw size discrepancy is a orthopedic or (jawbone) problem. Additionally, the teeth are crooked, superuped and she has a classic "underbite". Typical solutions are orthodontics and jaw surgery to make the lower jaw smaller. Jaw surgery becomes necessary if the face is out of proportion. In this case, her face was fine and surgery was eliminated as she chose a complete bite reconstruction with porcelain veneer crowns.

Angular Appearance
Dr. S. Muslin


Tetracycline Stain, Peg Lateral Incisors, Retained Baby teeth, Defective Enamel, The teeth were stained with the antibiotic tetracycline during the development of her permanent teeth at about 4 years of age. The lateral incisors were peg shaped and out of proportions with the sizes of the other permanent teeth. The treatment involved non-invasive porcelain veneers and porcelain veneer crowns that required no grinding of her natural teeth. The color of the veneers was able to hide the color as the dentist bonded the stained defective enamel before the veneers were made

Baby Teeth - Peg Laterals
Dr. S. Muslin


Deep overbite, bite collapse, Congenitally missing lateral incisors, teeth drifting, lost canine guidance, lower anterior teeth superupted, Broken edge of the central incisor

Congenitally Missing Lateral Incisors
Dr. S. Muslin


Lower teeth superupted, deep overbite, missing congenitally the upper lateral incisors and back molar teeth, gum recession and tooth erosion, teeth are drifting, bite is not stable, tooth abrasion, bruxism and heavy tooth wear as the angles on the lower front teeth are from clenching and tooth grinding or bruxism

Super Eruption - Missing Incisors
Dr. S. Muslin


A common cause of missing two laterals but with exaggerated spacing. Flaring of the 4 anterior teeth is quite significant. Delays in treatment promoted an increase in orthodontic issues affecting overall bite.
Large Tooth Gaps Orthodontic Flared Anteriors
Missing Teeth Gaps
Kristin Petulla, DDS


Another example of congenital malformations of upper anterior tooth structures (peg laterals) and multiple diastemas. Many patients delay treatment well into their adult years. Compounded occlusal problems may emerge for some patients, depending on the existence of early signs of impending malocclusion. In this case, 4 anterior teeth appear to be "out of occlusion", creating a reverse smile line.

Treatments can include crowns, implants, bridgework, partials, custom porcelain laminates.

Birth Defect Peg Laterals Male Adult
Adult Male Peg Laterals
Paul Sussman, DMD


Missing laterals for an adult female. Fortunately, ortho treatment was not performed during early years to move teeth together (not an uncommon practice). The patient was equally fortunate not to acquire other generalized teeth alignment issues.

Treatments can include implants, crowns, partial or bridgework.

Birth Defect Peg Laterals Female Adult
Female Missing Laterals
Edward Leventhal, DDS


A young male adult with an unusual genetic defect that caused the eruption of a good sized tooth into an area that created unique bite problems in addition to the cosmetic impactit had on his good looks. Extraction was required but left a gaping diastema that could be treated in several ways.

Recommended procedures could include adult orthodontics, dental implants, bridgework.

Birth Defect Extra AnteriorTooth
Congenital Defect - Extra Anterior Tooth
Ara Nazarian, DDS







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