Dysgnathia is the term used to describe misalignments of the jaw; it can affect the upper jaw, the lower jaw, or both. Dysgnathia is a generic term from dentistry, which summarizes all forms of possible congenital or acquired jaw malpositions. These can be malocclusions of the jawbone itself, but also malocclusions of single or multiple teeth in the upper or lower jaw, which are also summarized under the term dysgnathia.
What is dysgnathia?
The definition of a dysgnathia refers to deviations of any form from the regular dentition, also known as the regular bite. In dentistry, deviations from the regular bite are divided into three categories:
- Only class one, the so-called eugnathic tooth position, is considered normal; here there is no need for therapy. Whether a human dentition is eugnath or not, only the dentist or an orthodontist can determine.
- Category two is a slight misalignment of teeth, 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 denotes a significant forward bite of the mandible. In the field of jaw malocclusions, the term dysgnathia refers to a vertical, transverse or sagittal deviation of the normal jaw position.
Any deviation of the bony jaw from the norm is also called a defect axis. The so-called chin dysplasia, visible externally as a protruding, receding chin, is also a form of dysgnathia.
Causes
Congenital malocclusions of the jaws lead to permanent overload of the entire periodontium, the temporomandibular joints but also the masticatory muscles. If no therapeutic intervention is taken, premature tooth loss may be the result. Under normal conditions, the teeth in the upper and lower jaws line up like a string of pearls. In addition, the upper teeth bite lightly over the lower teeth. Typically, the incisors of the lower jaw also touch the backs of the incisors of the upper jaw. Any congenital deviation from this pattern is called dysgnathia in orthodontics. Acquired dysgnathias, which have to be treated much less frequently in dental and orthodontic practice, can be caused by poor oral hygiene or by bony destruction in the jaw region, by tumors or inflammations. Infantile dysgnathia are not always directly visible from the outside because the jawbone is still growing. The deviations are often only a few millimeters in congenital jaw malpositions in infancy. Early diagnosis is therefore very important, so that later, in adolescence or as an adult, this does not result in a manifest finding that is difficult to treat.
Symptoms, complaints, and signs
The main reason why a patient with dysgnathia visits a dentist or an orthodontist is the external appearance. However, aesthetic problems must basically be considered separate from functional problems. The rows of teeth do not fit together optimally if the lower or upper jaw protrudes or recedes too far or another form of dysgnathia is present. Typically, many jaw malocclusions also cause discomfort with speaking or eating. The sensitive musculature of the jaw joints often reacts tense. These tensions can take on extreme proportions, so that they not only remain localized, but can even spread to the neck-shoulder or back muscles. It is not uncommon for those affected to be unable to close their lips. Movements of the temporomandibular joints cause pain or a cracking sensation 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 expression, which is considered to be quite decisive in determining whether a face is perceived as attractive or less attractive. The overall facial profile is also essentially 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 therefore also experience psychological distress.
Diagnosis
The course of disease for all forms of dysgnathia depends on correct diagnosis by a dentist or orthodontist. Inspection of teeth and jaws already allows the doctor to make a definite diagnosis.Imaging procedures, X-rays, are common to harden the diagnosis. In addition, patients must expect that plaster casts will also be made. Dysgnathia diagnosed early has a good prognosis today because of the conservative and surgical treatment options available.
When should you see a doctor?
In general, dysgnathia requires seeing a doctor when there is a misalignment of the jaw. This misalignment is congenital in some people, so it is usually detected right after birth and can be corrected. If dysgnathia occurs after an accident or after a blow to the face, an emergency doctor should be called or the hospital visited. Furthermore, tension and pain in the area of the jaw and mouth may also indicate the disease. A medical examination should also be performed if facial expressions are distorted or unnatural. Either a dentist or an orthodontist can be consulted. Furthermore, many affected persons also suffer from psychological complaints due to dysgnathia, so that in this case a psychological examination and treatment can be useful. In most cases, there is a positive course of the disease and the complaints can be relatively well limited and alleviated.
Treatment and therapy
Any therapy for dysgnathia always strives for category one, i.e., regular dentition. This can be pursued conservatively or surgically, but is not possible in all cases. In order to be able to reliably detect malocclusions of the temporomandibular joints, a bite registration is required before any treatment of a dysgnathia in adults. Depending on the form of dysgnathia, the patient must first undergo preoperative orthodontic therapy. This consists of shaping the dental arches, eliminating malocclusions, gaps between teeth or crowding. However, these treatment measures can temporarily lead to a deterioration in aesthetics. Before the main surgery, a simulated, model surgery is performed with the help of X-rays, dental impressions and 3D images of the jaw. Only in the main surgery the defects in the vertical or sagittal planes of the jaw are finally corrected. After such a complex orthodontic procedure, patients usually have to wear loose elastics or bite splints for weeks or months.
Outlook and prognosis
As a rule, dysgnathia must always be treated, even if it is already congenital. This completely resolves most of the restrictions and results in a positive course of the disease. Self-healing does not occur with this disease. If dysgnathia is not treated, patients suffer from pain and tension in the muscles of the jaw. This also leads to difficulties in taking food and liquids, so that dehydration or various deficiency symptoms can occur. The pain can significantly reduce the quality of life. The facial expressions of the affected person are also disturbed by dysgnathia, and the teeth can also be damaged by the malpositions. Treatment of dysgnathia is usually carried out through various surgical procedures and completely alleviates the discomfort. Complications and other discomforts do not occur and there is a complete healing. This also ensures ordinary development of the child. The life expectancy of the patient is not reduced by the disease. The therapy of the disease can be supported by self-help measures.
Prevention
Prophylaxis is only possible against acquired forms of dysgnathia. However, by far the majority of dysgnathias requiring treatment are congenital, i.e. genetically determined, and direct prevention against them is unfortunately not possible.
Aftercare
In the case of dysgnathia, the affected person is primarily dependent on an early diagnosis, so that there are no further complications or complaints. The earlier the disease is detected in the process, the better it can be treated and the better the further course of dysgnathia usually is. The measures or possibilities of an aftercare are mostly strongly limited or only hardly possible, so that the fast and correct correction of the complaints stands in the foreground.In most cases, those affected are dependent on a surgical intervention that can completely alleviate and limit the symptoms. This intervention should be performed relatively early in order to avoid aesthetic discomfort later in life. In many cases, the affected person should rest and take care of the body after such an operation. Exertion or other stressful activities should be avoided in any case. Even after a successful surgery, dysgnathia requires regular examinations by a doctor. Wearing a bite splint can also alleviate the discomfort. In case of psychological upsets, psychological treatment should also be sought.
What you can do yourself
In the case of dysgnathia, congenital malocclusions of the jaws usually lead to constant overloading of the entire tooth-supporting apparatus, as well as the jaw joints and the masticatory muscles. Dysgnathia, although often disfiguring, is therefore not only a cosmetic problem. If the affected person does not take countermeasures, there is a risk of premature tooth loss. The treatment of dysgnathia is often accompanied by a lengthy and complicated preoperative orthodontic therapy. In most cases, surgical measures can only be taken afterwards. The best self-help measure is therefore to find a competent dentist who specializes in eliminating this disorder and to receive comprehensive information about all the necessary treatment measures. This is 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 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 persons who suffer greatly mentally from their appearance or from the therapy measures should consult a psychotherapist in good time.
