As malocclusion deformities are referred to the jaw, can the upper jaw, lower jaw or both be affected. Dysgnathia is a generic term from dentistry that summarizes all forms of possible congenital or acquired jaw misalignments. This can be a misalignment of the jawbone itself, but also a misalignment of one or more teeth in the upper or lower jaw, which are also summarized under the term dysgnathia.
What is dysgnathia?
According to Etaizhou, the definition of a dysgnathia refers to any form of deviation from the standard tooth system, also known as a standard bite. The deviations from the regular bite are divided into three categories in dentistry:
- Only class one, the so-called eugnathic tooth position, is considered normal; there is no need for therapy here. Only the dentist or an orthodontist can determine whether a human set is eugnathic or not.
- Category two is a slight malocclusion in which the anterior cusp of the first upper molar bites in front of the middle central dimple of the first lower molar.
- Category three of a dysgnathia describes a significant undershot of the lower jaw. In the area of jaw misalignments, the term dysgnathia describes a vertical, transversal or sagittal deviation from the normal jaw position.
Any deviation of the bony jaw from the norm is also known as the axis of error. The so-called child dysplasia, visible outwardly as a protruding, receding chin, is a form of dysgnathia.
Congenital misalignments of the jaws lead to permanent overloading of the entire tooth support system, the jaw joints but also the masticatory muscles. Failure to intervene therapeutically can result in premature tooth loss. Under normal conditions, the teeth in the dentition of the upper and lower jaw line up like a string of pearls.
In addition, the upper teeth easily bite over the lower teeth. Typically, the lower incisors also touch the back of the upper incisors. Any congenital deviation from this pattern is called dysgnathia in orthodontics.
Acquired dysgnathias, which have to be treated far less frequently in dental and orthodontic practice, can result from poor oral hygiene or from bone destruction in the jaw area, from tumors or inflammation. Childish dysgnathias are not always directly recognizable from the outside because the jawbone is still growing.
In the case of congenital jaw misalignments in infancy, the deviations are often only a few millimeters. An early diagnosis is very important so that later in adolescence or as an adult there are no manifest and difficult to treat findings.
Symptoms, ailments & signs
The main reason a patient with dysgnathia see a dentist or an orthodontist is because of their physical appearance. In principle, however, aesthetic and functional problems must be viewed as separate aspects. The rows of teeth do not fit together optimally if the lower or upper jaw is too far back or protruding or if there is another form of dysgnathia.
With many jaw misalignments, problems with speaking or eating are typical. The sensitive muscles of the temporomandibular joints are often tense. This tension can take on extreme proportions, so that it not only remains locally limited, but can even spread to the neck, shoulder or back muscles. It is not uncommon for those affected to fail to close their lips.
Movement of the temporomandibular joints causes pain or a cracking sound in affected patients. The aesthetics of the jaw play a decisive role in the harmonious facial expression. Closely related to this is the language of facial expressions, which is seen as crucial for whether a face is perceived as attractive or less attractive.
The entire facial profile is also largely determined by the position of the teeth. Only straight teeth and a closed dental arch allow a correct jaw position in all planes. Patients with dysgnathia also experience psychological distress.
The course of all forms of dysgnathia depends on the correct diagnosis by the dentist or orthodontist. The inspection of teeth and jaws already allows the doctor to make a reliable diagnosis. Imaging procedures, X-rays, are common for confirming the diagnosis.
In addition, patients must expect plaster casts to be made. Dysgnathias diagnosed at an early stage now have a good prognosis because of the conservative and surgical treatment options available.
When should you go to the doctor?
As a rule, a doctor must be consulted in the case of dysgnathia if the jaw is misaligned. This misalignment is congenital in some people, so that it is usually recognized and corrected immediately after birth. If the dysgnathia occurs after an accident or a slap in the face, an emergency doctor should be called or the hospital should be visited.
Furthermore, tension and pain in the area of the jaw and mouth can also indicate the disease. A medical examination should also be carried out if the facial expressions are distorted or the facial expression is unnatural. Either a dentist or an orthodontist can be visited.
Furthermore, many sufferers also suffer from psychological complaints due to the dysgnathia, so that in this case a psychological examination and treatment can be useful. In most cases, the disease progresses positively and the symptoms can be limited and alleviated relatively well.
Treatment & Therapy
Any therapy for dysgnathia always strives for category one, i.e. the regular interlocking. This can be aimed at conservatively or surgically, but is not possible in all cases. In order to be able to reliably identify misalignments of the temporomandibular joints, a bite registration is required before any treatment for dysgnathia in adults.
Depending on the type of dysgnathia, the patient must first undergo preoperative, orthodontic therapy. This consists in the shaping of the dental arches, the removal of misaligned teeth, tooth gaps or constrictions. However, these treatment measures can temporarily lead to a deterioration in aesthetics.
Before the main operation, a simulated, model-like operation is carried out using x-rays, dental impressions and 3D images of the jaw. The errors in the vertical or sagittal planes of the jaw are then finally corrected in the main operation. After such a complex orthodontic procedure, patients usually have to wear loose elastic bands or bite splints for weeks or months.
Outlook & forecast
As a rule, dysgnathia must always be treated, even if it is already congenital. As a result, most of the restrictions are completely resolved and the disease progresses positively. Self-healing does not occur with this disease.
If there is no treatment for the dysgnathia, the patient will suffer from pain and tension in the muscles of the jaw. This also leads to difficulties in taking food and liquids, which can lead to dehydration or various deficiency symptoms. The pain can significantly reduce the quality of life. The facial expressions of the person affected are also disturbed by the dysgnathia, whereby the teeth can also be damaged by the misalignment.
The treatment of the dysgnathia is usually carried out through various surgical interventions and completely alleviates the symptoms. Complications and other complaints do not arise and there is complete healing. This also ensures the child’s normal development. The life expectancy of the patient is not reduced by the disease. The therapy of the disease can be supported by self-help measures.
Prophylaxis is only possible against acquired forms of dysgnathia. The vast majority of dysgnathias that require treatment are congenital, i.e. genetically determined; unfortunately, direct prevention is not possible.
In the case of dysgnathia, the person concerned is primarily dependent on an early diagnosis so that there are no further complications or complaints. The earlier the disease is recognized, the better it can be treated and, in most cases, the better the further course of the dysgnathia. The measures or options for follow-up care are usually very limited or hardly possible, so that the quick and correct correction of the complaints is in the foreground.
In most cases, those affected are dependent on an operation that can completely alleviate and limit the symptoms. This procedure should be carried out relatively early so that there are no aesthetic complaints at a later age. In many cases, the person concerned should rest after such an operation and take care of the body.
Exertion or other stressful activities must be avoided in any case. Even after a successful procedure, regular examinations must be carried out by a doctor in the case of dysgnathia. Wearing an occlusal splint can also alleviate the symptoms. In the case of psychological upset, psychological treatment should also be sought.
You can do that yourself
In the case of dysgnathia, congenital misalignments of the jaws usually lead to constant overloading of the entire tooth support system as well as the temporomandibular joints and the masticatory muscles. Dysgnathia, although often disfiguring, is therefore not just a cosmetic problem. If the person concerned does not take countermeasures, there is a risk of premature tooth loss.
The treatment of dysgnathia is often associated with lengthy and complicated preoperative orthodontic therapy. Surgical measures can usually only be taken after this. The best self-help measure is therefore to find a competent dentist who specializes in the elimination of this disorder and to obtain comprehensive information on all necessary treatment measures.
Because many patients also have to adjust mentally to the lengthy and often strenuous therapy. Qualified doctors can be researched on the Internet. In addition, the medical associations and the health insurance companies provide information.
For those affected, it is especially important not to lose patience or fall into depression during the usually lengthy treatment. This is especially true because the external appearance usually deteriorates during the therapy. Affected people who suffer emotionally from their appearance or from the therapeutic measures should consult a psychotherapist in good time.