The topic of conversation this time is malocclusion.  This is a term you will hear from Dr. Kruse when you visit our office as a new patient.  A malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaws close. In common terms, when you bite together and your teeth don’t fit correctly.  The word literally means “bad bite”.

Your orthodontic treatment is based in part on the type of malocclusion you have.  This diagnosis is instrumental in determining the length of treatment, if extractions of teeth are necessary, whether rubber bands or Herbst/Forsus appliance will be necessary or even if you will be a candidate for orthognathic surgery.  It can even have an effect on the type of retainers you will be required to wear when your active orthodontic treatment is completed.

Types of Malocclusion

There are three types of malocclusion (as established by Dr. Edward Angle, the father of Orthodontics). To learn more about Dr. Angle visit  The specific type of malocclusion is determined by the way the upper first molar fits with the lower first molar on each side of the mouth.  A normal fit occurs when the upper teeth are slightly forward of the lower teeth and when biting, a small portion of the lower teeth are covered by the upper teeth (view A of diagram).

  • Class I malocclusion – upper and lower molars fit together properly but teeth can be crowded or spaced unevenly. Cross bites, rotations and constricted jaws (arches) can also occur with this type of malocclusion. (view B of diagram)
  • Class II malocclusion – the lower molars fit further back on the upper molars which results in the chin being drawn back (sometimes called a weak chin). The same issues as stated for a Class I malocclusion can occur here.  A Herbst or Forsus appliance is occasionally utilized to help correct this type of bite.  Sometimes, orthognathic surgery is required to correct a Class II bite.(view C of diagram)
  • Class III malocclusion – the lower molars fit too far forward of the upper molars and this results in a prominent jaw where the lower teeth fit in front of the upper teeth. Again, teeth can be crowded, spaced, rotated, in crossbite, or constricted arches with this bite.  In severe cases, this can require surgery to be completely corrected. (view D of diagram)


Please visit our “before and after” page to see some examples of these types and the results that were attained.

Keep in mind that your actual treatment plan is determined by this malocclusion along with other factors, such as:  crowding, crossbite, growth pattern, age, rotations, constricted jaws to name a few.  Also realize that family members can have completely different malocclusions which translate into different treatment plans and lengths.

If you have questions, call our office at 616-656-4155 for a complimentary exam.  If you are a current patient, just ask at your next visit.