If you have a bite issue as an adult, then you’re in good company. Whether it’s an overbite, an underbite, midline misalignment, or another issue, bite issues happen often. In this guide, we’ll cover everything you should know about midline misalignment, including its common causes and the best treatment options for adults.
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What is Midline Misalignment?
Midline misalignment is a minor dental misalignment in which the teeth are slightly off-center. Normally, the front teeth (both top and bottom) are centered right below the nose, so you could trace a straight line between them. Put another way, if you split a face exactly down the middle, half the teeth would go to each half. But in a midline misalignment, the front teeth skew off to one side or the other. Usually it affects only one row (sometimes called an arch) of teeth, but it can affect both at the same time.
In general, midline misalignments are pretty minor—a result of overcrowded or missing teeth. Sometimes, these types of midline misalignments are so minor that they go entirely unnoticed. That said, some tougher cases of midline are actually caused by a misalignment of the facial bones themselves, skewing the entire arch of teeth off to one side.
How Do I Know If I Have a Midline Misalignment?
Midline misalignment wasn’t extremely well-known until Tom Cruise started using braces to correct his misalignment back in 2002. Since then, people have become a bit more aware of the issue, and you might be able to spot one on your own.
When looking in a mirror, you can focus on your two front teeth: where do they fall? Are they lined up directly underneath your nose, or do they sit off to the left or right? Do they line up with the middle teeth below them, or are they off-center? If they’re slightly off-center, then you probably have a midline misalignment.
Of course, this isn’t a scientific method. And in some cases, your midline misalignment might be so minor that you won’t be able to spot it yourself. Your dentist will be able to tell you for sure, and more importantly, he or she will tell you if it’s a problem you need to correct.
Does a Midline Misalignment Cause Any Issues?
It’s uncommon for a midline misalignment to cause major issues, but we’d be remiss not to mention them. Here’s a quick glance at potential problems a midline misalignment can cause:
- Inefficient chewing
- Discomfort while chewing
- Worn enamel due to extra stress on certain teeth, especially in the back teeth
- Poor smile aesthetics
None of those problems are extremely concerning. But if you’re worried about the long-term health of your enamel or the simple aesthetics of your smile, you might consider treating your midline misalignment.
Do I Need to Correct My Midline Misalignment?
In most cases, you can leave a midline misalignment ‘as is’ since it rarely causes medical issues. If you decide not to treat it, you probably won’t even notice any problems.
That said, if your midline misalignment is caused by a misaligned jaw, or it’s complicated by another bite issue like an overbite or crossbite, you might experience complications. While these cases are uncommon, they are important to consider for your long-term oral health.
Treating a midline misalignment can help alleviate any of the above issues, but it’s rarely a medical necessity. For most people, the benefit to correcting a midline misalignment is aesthetic.
Treating Adult Midline Misalignment From Home With Clear Aligners
Good news! If your midline misalignment isn’t too severe, you can probably treat it with clear aligners.
Invisalign was the first company to introduce clear aligners, but they didn’t have a monopoly for long. Several other companies created their own clear aligner trays. At first, these Invisalign competitors were only available through a dentist or an orthodontist. But by 2014, companies like Smile Direct Club cut out the middleman and provided home-based clear aligners directly to the consumer.
If you choose to use home clear aligners to correct your midline misalignment, here’s what you can expect:
- Order an impression kit from your chosen aligner company and take impressions of your teeth. Alternatively, if you opt for Candid or Smile Direct, you can schedule an appointment and have digital scans taken of your teeth.
- The company will review your impressions and create a treatment plan for you. Once you review and approve the plan, the company will manufacture your aligners and ship them to you.
- You wear your aligners as prescribed: usually 20-22 hours per day, with a week or two of wear per aligner. Wearing the aligners shifts your teeth into their new positions.
- Once you’ve worked through all of the different aligners in your treatment plan, you’ll wear your post-treatment retainers to protect your new smile.
In general, home clear aligners are faster than traditional methods like braces and Invisalign. In fact, home clear aligners are the same principle as Invisalign. However, home aligners don’t have additional attachments, so they’re limited to treating minor-to-moderate cosmetic cases only. If your midline misalignment is relatively severe, you’ll need to go with a more powerful option like Invisalign or braces.
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Other Treatment Options: Braces, Invisalign & Surgery
The best treatment method for your midline misalignment depends on the severity and cause of your case. For most people, their midline misalignment is caused by simple overcrowding, or the teeth just emerged in the wrong position. Those cases are relatively easy to correct; all it takes is pulling on the teeth to move them into the correct positions.
However, some cases of midline misalignment occur because the jawbone itself isn’t in the right position or it’s shaped incorrectly. If that’s true, the midline misalignment can still be corrected; it just requires a lot more force. Fortunately, there are proven treatment methods to correct both your bones and your teeth. Let’s talk about the top methods for correcting your midline misalignment.
Braces often get a bad wrap for being uncomfortable, ugly, and pricey. And technically, those are all true criticisms. The wires and brackets used in braces can cut into your cheeks and gums (especially when they’re first installed). And braces typically cost around $5,000.
But despite those downsides, braces are still around today for a good reason. They’re the most universally-accepted method to straighten your teeth. And when it comes to correcting your midline misalignment, braces will be able to handle your case—even if your midline misalignment is caused by your bone structure.
As a whole, braces allow for more nuanced movements thanks to metal appliances and elastics. Over the course of your treatment (which usually lasts between 1.5-2 years), your orthodontist can gradually move both your teeth and your jaw into perfect alignment.
Invisalign first entered the teeth alignment scene just before 2000. And when they did, they really shook things up by correcting two of the biggest complaints about braces: ugliness and discomfort. Instead of using wires and brackets, Invisalign uses clear trays molded to your teeth. The trays are nearly invisible, and there’s no metal in your mouth to cut up your cheeks.
That said, you will still experience some discomfort while wearing your Invisalign aligners. That’s inevitable when you’re shifting your teeth from their positions. And Invisalign isn’t really any faster or cheaper than traditional braces; the average cost is also around $5,000. So if you’re looking for the fastest method to treat your bite issue, you’ll need to look elsewhere.
Like braces, Invisalign can treat most midline misalignments regardless of the cause. That’s because Invisalign uses proprietary SmartForce attachments and elastics in addition to your aligner trays. Those extras allow for the nuanced movements necessary to treat both your jaw and your teeth.
Corrective surgery is definitely the most drastic method on this list, but fortunately, for most people, it’s not necessary. Your care provider will only recommend surgery if all the other options we’ve discussed will not correct your midline misalignment (and that’s a very rare occurrence, to be honest). If you go this route, your surgeon will shift your jaw into alignment by force.
Understandably, surgery is the most expensive method to correct a midline misalignment. It will also cause you the most discomfort (especially up front). The recovery time is significant, and in many cases, you’ll need to adjust your eating habits for a while. Surgery isn’t right for everyone. But it’s certainly the most powerful method.
Which Treatment Option Is Right For You?
Midline misalignment is a fairly common dental issue, and it rarely causes long-term problems. But if you want to perfect your grin by treating your midline misalignment, then you’re in good company.
Everyone’s smile is unique, including all the charms and imperfections. And a unique smile needs a unique treatment. What works to treat one person won’t necessarily be right for you. But if you decide to treat your midline misalignment, odds are you’ll be able to use braces, Invisalign, or home clear aligners to get the results you want. We hope this guide will help you make the decision that’s right for you!
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