Mesial Bite

The AESTHETE dental clinic offers services for correcting mesial bite. This is one of the dentoalveolar anomalies characterized by the protrusion of the lower jaw relative to the upper jaw. This defect leads to a disruption of normal occlusion, i.e., contact between the upper and lower teeth, which can have various negative consequences.

Mesial Bite: General Information

This type of bite implies that the lower jaw is overly developed and protrudes forward. Because of this, the teeth of the upper row are overlapped by the lower teeth, and the jaws cannot close normally. The face looks unfriendly, and its proportions are distorted. For this reason, a person may have difficulties communicating with others, leading to psychological problems.

Modern medicine can correct a mesial bite. It is easier to do this in childhood or adolescence when the bone tissue is still forming. However, there are methods to address the problem in adults as well.

Why Mesial Bite is Dangerous

Problems arising in people with this dentoalveolar anomaly include:

• Inability to bite hard foods;
• Difficulty chewing food;
• Rapid wear and increased sensitivity of the front teeth;
• Speech disorders;
• Tooth mobility, destructive processes in the periodontal tissues that hold them in the correct position, due to improper load distribution;
• Increased risk of cavities, gingivitis, and the accumulation of tartar deposits;
• Painful sensations in the smile zone;

Posture disorders.

Distorted facial features lead to psychological discomfort. People around may perceive a person with this bite defect as angry, tense, or aggressive and capable of corresponding behavior. Therefore, they avoid interaction, and the patient becomes withdrawn. If it is a child, they may lag behind peers in mental development and find it challenging to study.

• The pathology may be combined with other dentoalveolar anomalies, such as open or crossbite, complicating treatment.

Symptoms of Mesial Bite

This defect can be identified visually by the structure of the face – the massive lower jaw protrudes forward. However, for an accurate diagnosis, additional examination by a doctor is necessary.

Symptoms of mesial bite are divided into external and intraoral.

External symptoms include:

• The chin and lower lip are significantly protruding forward, disproportionately enlarged;
• Retraction of the upper lip;
• Gaping mouth, i.e., a noticeable gap between the lips;
• Angry, tense, aggressive facial expression in profile;

The middle third of the face in profile appears concave, sunken.

• Intraoral symptoms include:
• Upper incisors overlapped by lower ones;
• Misalignment of molars relative to each other, known as the mesial step;
• Wide interdental spaces;
• Lower teeth inclined inward into the oral cavity;

Crowded teeth in anatomically incorrect positions.

• Posture can also indicate the presence of a mesial bite. The anomaly causes the temporomandibular joint to be in the wrong position, changing the body's balance, which may slightly lean back. At the same time, the pelvic bones protrude forward.

Causes of Pathology Development

The occurrence and development of this defect are influenced by heredity, congenital, and acquired factors.

In 20-40% of cases, the pathology arises due to genetic reasons. Doctors detect features of the facial part of the skull that are hereditary.

The problem may arise even before the child is born. The main reasons in this case are:

• Diseases suffered by the woman during pregnancy;
• Hypoplasia of the jaw bone associated with metabolic disorders;

Birth injuries received by the newborn.

• In early childhood, the appearance of bite defects is caused by:
• Artificial feeding;
• Rickets;
• ENT diseases forcing the child to breathe through the mouth;
• Associated tooth anomalies – extra units on the lower jaw, partial or complete edentulism (absence of teeth) on the upper jaw;

Disruptions in the timing and sequence of normal tooth eruption.

There are also behavioral factors that can provoke the appearance of this dentoalveolar anomaly. The defect occurs if a child sucks their fingers, upper lip, or various objects they put in their mouth. It can appear as a consequence of frequent sleeping with the head down on the chest or due to the habit of placing a fist or hand under the chin while sitting.

• Sometimes, the pathology arises due to osteomyelitis or jaw tumors, or poorly performed correction of a cleft palate.

Classification and Stages of Mesial Bite Development

Modern dentistry identifies several types of this anomaly. This division helps doctors determine the nature of the defect and its severity, making it easier to choose appropriate treatment.

Based on the cause of occurrence, there are three types of mesial bite:

• True – arises due to congenital factors, characterized by the forward protrusion of the lower jaw;
• False – develops under the influence of external factors, characterized by a normal-sized lower jaw and a reduced upper jaw;
• Combined – symptoms of true and false defects are combined.

According to the size and position of the jaws, the following variants are found:

• Protrusion of the lower jaw forward;
• Retraction of the upper jaw backward;
• Normal lower jaw combined with an underdeveloped upper jaw;
• Normal upper jaw combined with a significantly developed lower jaw.

The following forms of mesial bite are also distinguished:

• Dentalveolar – the main factor causing the defect is the abnormal position of the teeth;
• Gnathic (skeletal) – problems are caused by the mismatch of the sizes or positions of the jaw bones;
• Mixed – combines features of gnathic and dentoalveolar forms.

According to the width of the gap between the front teeth units:

• Grade I – the gap width does not exceed 2 mm, the pathology signs are not visually detectable;
• Grade II – the gap reaches 10 mm, the chin protrudes forward, and the lower dental arch contacts the inner surface of the upper lip;
• Grade III – the gap is more than 10 mm, and the lower jaw significantly protrudes forward.

Complications of Mesial Bite

It is important to identify the pathology in a timely manner and begin treatment. If this is not done, the anomaly will progress and serious complications may arise.

The most common problem is the disproportion of the face. The lower jaw becomes more massive and protrudes forward, resulting in a specific concave profile. A person with such an appearance is perceived as constantly angry and aggressive, which can impact their psycho-emotional state and lead to difficulties in communicating with others.

Due to improper teeth closure, chewing problems arise, making it difficult to bite hard food.

Disruptions in the chewing apparatus over time lead to the gastrointestinal tract failing to function normally. Problems also arise with the temporomandibular joint: dysfunction, inflammatory, and dystrophic diseases. Pain is felt in the joint, which radiates to the head and ear area.

If the reverse overlap of the teeth is minor, the front teeth align edge-to-edge, leading to increased wear. As a result, the front teeth will gradually start to deteriorate.

Diagnosis of Mesial Bite

The main symptoms of this anomaly can be determined visually. When a patient comes for a consultation, the doctor examines them, paying attention to the position of the lower jaw, profile features, and takes basic anthropological measurements. A functional test is required to distinguish true mesial bite from false.

The doctor examines not only the teeth but also the condition of the mucous membranes, periodontium, and hard palate. With this pathology, the nasolabial folds become more pronounced, while the chin fold becomes less noticeable.

Additionally, the following are performed:

• Photographs taken face-on and in profile;
• X-rays – panoramic, in various projections;
• Computed tomography (CT);
• Taking impressions – diagnostic models are made in the laboratory based on these.

Ordinary and X-ray images allow:

• Assessment of the state of the dentoalveolar system, determination of the teeth's position relative to each other, measurement of the distance between the dental arches;
• Examination of the condition of the hard tissues;
• Determination of the presence of permanent tooth buds in the temporary bite.

CT scans provide information about the temporomandibular joint. It is important to determine the position of its heads: if it is incorrect, atypical, the joint will not function normally.

Treatment of Mesial Bite

Correction is carried out after diagnosis. Doctors gather information, make a diagnosis, and develop an appropriate treatment strategy, considering the patient's age, individual characteristics, and the nature and severity of the anomaly.

The main methods of defect correction are:

• Orthodontic;
• Orthopedic;
• Surgical;
• Physiotherapeutic – including massage and myogymnastics.

Correcting mesial bite in children is easier than in adults. The average correction duration for a child is 2 years, while for patients older than 18, it ranges from 3 to 5 years.

Treatment in Children Under 6 Years Old

For young school-age children, it is especially important to eliminate factors that negatively affect the development of the facial bones. These include:

• Prolonged pacifier sucking;
• Habit of sucking a finger;
• Consuming food in liquid puree form;
• Mouth breathing.

To address this, removable orthodontic appliances such as mouthguards and plates are used. If it is necessary to lengthen the frenulum of the tongue, a surgical operation is performed. This simple procedure is done under local anesthesia, takes little time, and does not require long recovery.

Gum massage is helpful if the upper jaw is underdeveloped.

Myogymnastics, or exercises aimed at strengthening the muscles around the teeth, are also effective. These may include biting the lower lip with the upper front teeth and gently pressing the tongue against the upper teeth. These exercises can be done playfully, and children perform them easily. Myogymnastics normalizes the development of the lower jaw, preventing it from protruding forward.

Treatment in Children Aged 6 to 12 Years

In younger and middle school-age children, the main correction method is through orthodontic appliances. Doctors use various solutions:

• Orthodontic plates – ensure proper alignment of the jaws relative to each other, returning the teeth to their natural position;
• Dental mouthguards – provide the necessary positioning for the teeth;
• Orthodontic headgear – necessary for chin fixation, preventing abnormal growth of the lower jaw.

Treatment in Children Over 12 Years Old

At this age, braces can be used. These are non-removable constructions typically installed on both jaws. They allow the bite to be corrected by slowly moving the teeth in the desired direction through constant pressure. The load is minimal to avoid causing pain. Thus, such treatment is quite prolonged.

Treatment in Adults

Correction of mesial bite in adult patients is more complicated and takes more time. By this age, jaw deformities become more pronounced, and the bone tissues have already formed and become dense.

The dentoalveolar form of pathology is treated with non-removable constructions and aligners. Wearing aligners is more aesthetic and provides a higher level of comfort. These systems are mouthguards made of transparent elastic plastic based on individual impressions of the patient’s teeth. They can be put on and taken off independently without visiting the doctor each time. They are almost invisible from the outside, allowing you to talk to others and smile without worrying that they will see signs of treatment. This option is often preferred by people who need to speak in front of an audience, attend meetings, and participate in business negotiations.

Orthodontic systems can only align the teeth. They do not affect the size of the jaws or their position.

If mesial bite in gnathic form is diagnosed, orthodontic methods are combined with surgical intervention. Depending on the specific situation, doctors may remove teeth or perform jaw surgery, such as:

• Excising part of the bone under general anesthesia;
• Shifting the jaw to eliminate asymmetry;
• Installing titanium plates on bone fragments, which will need to be removed later.

The result achieved during the surgery is fixed with braces. To strengthen the jaw muscles, myogymnastic exercises should be performed. The doctor selects a set of exercises and shows how to do them. It is enough to perform them twice a day, for 5-10 repetitions.

Prognosis. Prevention

Correction of this pathology shows the best results if started at the stage of primary or mixed dentition. In this case, the effectiveness of treatment exceeds 90%.

Correction is also possible in adulthood. There are methods to eliminate functional and aesthetic disorders. However:

• Treatment becomes more prolonged;
• Correction is carried out in several stages;
• Different specialists are needed – an orthodontist, an orthopedist, and a dental surgeon.

The likelihood of developing mesial bite can be reduced. For this, it is necessary to ensure:

• Pregnancy and childbirth without complications;
• Breastfeeding;
• Timely treatment of diseases that slow down or disrupt normal jaw bone development;
• Correction of individual tooth anomalies.

Children should be discouraged from bad habits and monitored to ensure they sleep in the correct position. Breathing should also be controlled. If a child often breathes through their mouth, it can lead to various bite anomalies.

Proper oral care and timely treatment of cavities also play an important role.

The AESTHETE dental clinic is located in Dubai (UAE), Bluewaters Island. Our doctors have extensive experience in correcting mesial bite, including cases complicated by other dentoalveolar anomalies. We work with patients of all ages and use advanced techniques.

We invite you to schedule a consultation. If you have questions about the cost of services or the specifics of correcting bite defects, contact the clinic administrator. They will provide additional consultations, help you choose a time for a visit to the doctor, and schedule an appointment.