An illustration of a side view of a mouth showing the top teeth jetting forward and outward over the lower teeth

Understanding Overjet: What Causes Protruding Teeth and How to Treat It

Understanding Overjet: What Causes Protruding Teeth and How to Treat It

If your teeth look a bit like the image above, learn all about overjet and how to treat it

Do you have protruding teeth or know someone who does? Understanding the condition known as overjet can help shed light on what causes it and how it can be treated. In this article, we will explore the causes of protruding teeth and the various treatment options available. Overjet refers to the horizontal distance between the upper and lower front teeth when the jaw is closed. It occurs when the upper teeth extend too far forward, giving the appearance of protruding or sticking out. This can be a cosmetic concern for many people, affecting their self-esteem and confidence. Several factors can contribute to overjet, including genetics, thumb sucking, mouth breathing, and poor oral habits. If left untreated, overjet can lead to bite problems, difficulty speaking or chewing, and an increased risk of dental injuries. The good news is that overjet can be treated. Orthodontic treatment, such as braces or aligners, is often recommended to gradually move the teeth into their proper position. In some cases, additional dental procedures may be required to correct the underlying issues. If you are dealing with overjet, it is advisable to consult with a qualified orthodontist who can assess your specific case and recommend the most appropriate treatment plan. Correcting overjet not only improves the aesthetics of your smile but also promotes proper oral health.

What Exactly Is An Overjet?

An overjet is a malocclusion (imperfect positioning) of your upper and lower front teeth. This is when your upper front teeth stick out over your lower front teeth (see image at top of page). More specifically, the term overjet refers to the horizontal distance from the front of the lower teeth to the back of the upper front teeth. When biting on the back teeth, the lower front teeth should just lightly touch the back of the upper front teeth. Excessive overjet can cause social problems ("buck teeth") and protruding upper front teeth can be easily chipped, especially at young ages when falls on concrete are frequently seen.

Why Do I Have An Overjet?

An overjet or excessive overjet are often caused by genetics due to the positioning of your jaw and the shape of your face. In this instance, an overbite is just something some people are born with. These problems frequently occur when the upper jaw is well ahead of the lower jaw and is strictly developmental. Fortunately, we have many different ways to fix this kind of overjet.

Perhaps the more frequent cause of overjet are personal habits. Some individuals suck their thumbs, fingers, or lower lips, and others push their tongue up towards the back of their upper teeth with a strong force. This often occurs as a nervous habit, but that kind of force on the back of the teeth long term can often cause the front teeth to push forward over a long period of time, which eventually causes overjet.

If an overjet is caused by personal habits, the only way to permanently fix this kind of overjet is to stop the habit. Even if a patient goes through treatment with braces and their teeth are perfectly straightened, their teeth will become misaligned again if the bad habit resumes and is not corrected. There are devices/options that can be applied to the teeth to help a patient remind themselves to stop the habit if they find they have a hard time being cognizant of the habit.

How is Overjet Treated with Braces?

For a mild overjet, treatment is easily achieved with braces. The braces and archwire are applied to the teeth, as they normally would be with someone without overjet, and as the teeth slowly move into place the overjet is corrected. This could probably be done with removable appliances or aligners, depending on the circumstances.

For a moderate overjet, you may need both braces and headgear. The braces are applied normally, but headgear is added in order to slightly restrict the upper jaw from normal forward and downward growth while the lower jaw grows normally into a corrected skeletal position that will reflect the normal dental positions of the teeth.

What Is Headgear?

Headgear is a form of "dentofacial orthopedics," which is an orthodontist's way of saying, using appliances to guide facial growth. Headgear is a popular and an efficient option for correcting overjet created by a skeletal prognathia where the upper jaw is too far ahead of the lower jaw.

How is Overjet Treated with Aligners?

For bites with mild overjet, aligners could be a good option. If you must have aligners for a deep overjet or a mild overjet, Dr. Skarin might need to use braces first in order to have the control needed on the teeth to correct the vertical problem/overjet. Once Dr. Skarin feels the teeth are in a good position, he might then take the braces off and then put clear aligners on your teeth in order to finish up treatment.

For a moderate overjet, Dr. Skarin does not advise aligners being used for correcting anything other than mild cases of overjet. Overjets really do require a bit more heavy-duty movement. Aligners are great for aesthetics, but they are not a good option for more difficult cases.

Some orthodontic offices may use aligners to fix a moderate or severe overjet. Some offices may even suggest it is an equal or superior option to braces, but this is simply not the case. Orthodontists really want aligners to fix all treatment cases. Lots of orthodontists love aligners even more than patients do because it streamlines treatment for them and makes the process monetarily efficient to apply the same treatment for everyone. We do not believe in this philosophy. We do not account for our office efficiency or bottom line in how we treat our patients. We believe the best option for our patients should not be one-size-fits-all or even two-size-fits-all. We use the best option that we would choose even for ourselves. This is why Dr. Skarin does everything by hand for each of his patients. Individual attention and customization matters to us.

Ultimately, using aligners for a moderate or extreme overjet often ends up extending your treatment longer than you thought it would and results may also not be what you were expecting. Again, aligners are great, but they do have big limitations.

What Happens If I Do Not Correct My Overjet?

An overjet is not generally seen as a dire issue that must be fixed. It may be more difficult to maintain, depending on the causal factors. Several problems can eventually occur over time that will be problematic and overjet will normally continue to worsen throughout life. If the lower front teeth are making contact with the palatal tissue, there is a very real chance that as the bite deepens further, stripping/receding of the gum tissue and subsequent bone loss create gaps between the teeth at the receding gumline and teeth could potentially be lost at the worst.

Another significant problem with increasing overjet is that excessive incisal guidance (where the lower front teeth hit higher and higher on the inside of the upper front teeth, forcing the lower jaw to move backwards) will eventually get so bad that it will create backward pressure on the Temporo-mandibular joints (TMJ) when the back teeth cannot come together completely. This changing relationship will potentially create sharp, stabbing, ligamentous pain or aching muscle pain or both. Depending on how your teeth align, the overjet/overbite relationship could increase the risk of a chipped tooth since teeth could be angulated in adverse positions.

Obviously, the advantage of fixing an overjet is that it makes for a great smile, but it also makes the surfaces of the teeth much easier to keep clean. Cleaner teeth decreases the risk of plaque and tooth decay.

How Long Does It Take to Fix an Overjet?

Every overjet relationship is different, and unfortunately, there is no one set answer for fixing every overjet. Correcting an overjet can take anywhere from a few months to a few years. We wish there was a definitive length of time that we could tell you, but unfortunately there are too many variables at play to determine how long it might take. Everything from missed appointments to a tooth moving in a way the orthodontist might not expect can have an effect on treatment time, it really is hard to predict how long it will take to fix an overjet. Some people have a severe overjet, which can take years to fix, while others may have a mild overjet which can take several months.

Some people may have an overjet due to thumb sucking, which only requires the teeth to be moved into a more optimal position. Other people may have an overjet due to genetic factors. Fixing a genetic overjet is a process that is a bit more complicated and requires fixing your entire “bite” by repositioning how your teeth fit with your jaw. Dr. Skarin is skilled in adjusting teeth and jaw positioning with orthopedics, but in some instances, the skeletal relationship between the jaws is too great for orthopedic and orthodontic management alone. In that case, surgery may be required and recommended to fix some overjet or prognathic skeletal relationships. If this is needed, Dr. Skarin will refer you to an oral surgeon that he trusts with orthognathic surgery. After surgery, Dr. Skarin will use braces to align the teeth in each arch to manage the small relapse and settling changes that can occur for up to six months following the surgery.

Can I Do Anything to Make Treatment Go Faster?

The best way to correct an overjet as quickly as possible is to select the best treatment for your overjet. This is why we stress aligners as not being the best option. Even in the best case, aligners may fix an overjet, but we have other options that treat overjets much faster in the long run.

Regardless of your treatment option, if you make all of your appointments without skipping one, the treatment will take much less time than if you missed a bunch of appointments. Depending on your treatment option, following the direction of Dr. Skarin will also result in the fastest treatment.

Can An Overjet Correct Itself?

No. Unfortunately, an overjet will not correct itself. Usually, an overjet only gets worse with time. If the overjet is caused by a bad habit, such as thumb sucking, that habit will definitely result in a worsening overjet.

If you have an overjet and you still have some of your posterior baby teeth, it is possible that early intervention will help reduce the overjet once the rest of the permanent teeth come in. It is best to consult with an A.A.O accredited orthodontist, such as Dr. Skarin.

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