Midline misalignment is a very common problem that affects many adult patients. The midline of our teeth is the space between the center two teeth on the top and bottom, which should line up together and if you drew a line up the face, should bisect the nose up to the center of the space between the eyebrows.
Misalignment of the midline is often a cosmetic issue but can lead to dental complications if left untreated. Correcting misalignment is often done with either orthodontic treatment or veneers, depending on the severity of the case. Some problems that can result from midline misalignment include shifting teeth, headaches, chips or fractures in the teeth, and uneven wear.
What causes midline misalignment?
The most common cause of midline misalignment is simply that the adult teeth came in crooked but there are quite a few issues that can be a contributing factor to midline misalignment. Let's take a look at some of the most common reasons for midline misalignment.
Problems in baby teeth: The baby teeth help children learn to eat and speak properly as well as create space for the adult teeth. If a baby tooth is lost too early, the underlying adult teeth can drift to the empty space, causing the midline of the adult teeth to shift.
Thumb sucking: Thumb sucking is a natural method many babies adopt as a way to self soothe. Unfortunately, prolonged thumbsucking can cause orthodontic problems as they continue to grow. The continuous pressure on the front teeth caused by thumbsucking can cause the midline to deviate from center.
Malocclusion: Malocclusion is the term for a bad bite which may present in many ways such as an overbite, an underbite, or a crossbite. An overbite is when the upper teeth come out too far over the lower teeth and an underbite is the opposite, the lower teeth come out too far. When you have a crossbite, the teeth slant inward toward the tongue instead of sitting straight in the jaw. If the upper and lower teeth do not come together properly, the teeth can shift and cause misalignment.
Crowding and missing teeth: Crooked and crowded teeth often cause alignment issues simply because the teeth do not line up. Orthodontic therapy is often provided to adolescent patients once all of their adult teeth come in to prevent alignment issues later in life.
Additionally, when a tooth is congenitally missing or if one has to be extracted, the remaining teeth tend to shift together in an effort to fill the space, causing midline misalignment. When an extraction and restoration is planned, your dentist will provide an appliance for you to wear so that the teeth do not shift.
A misaligned midline is sometimes a matter of aesthetics and patients may seek treatment so that they feel more confident in their smile. But even if appearance is not of concern, it is important to see your dentist if you have any changes in your smile and to make sure your teeth are healthy.