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Updated on December 28, 2022
7 min read

Misaligned or Crooked Jaw

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The upper and lower jaws are meant to fit together evenly and painlessly. However, jaws can develop misaligned or uneven for several reasons. Injuries, childhood habits, and genetics can all misalign the jaw.

A misaligned jaw can cause pain and discomfort. It can also cause trouble with everyday activities, including talking, breathing, eating, and sleeping.

Corrective surgery may be necessary depending on your age and the severity of the misalignment. In other cases, orthodontic treatment and physical therapy should be enough to resolve the problem.

What Causes Jaw Misalignment?

The cause of someone’s jaw misalignment may be (but isn’t always) genetic. Sometimes multiple causes are involved, such as: 

Genetics

A misaligned or asymmetrical jaw may be a birth defect. Sometimes it may be due to a random mutation or exposure to certain chemicals during pregnancy. In other cases, it’s a hereditary trait (passed from parent to child).

Some genes make people more likely to have a protruding upper or lower jaw (prognathism).1, 2 A child might also be born with a smaller-than-normal lower jaw (micrognathism).3

Indirect Genetic Causes

In other cases, genes may be only part of the cause. A child might not be born with a misaligned jaw but inherit traits that make a misaligned jaw more likely.

For example, a child with a narrow upper airway may develop a mouth-breathing habit. This could lead to poor jaw development (such as a skeletal open bite) as they age.4, 5

Genetic Disorders

Sometimes a person’s upper and lower jaws don’t align because of a genetic condition that causes other symptoms. These conditions may be inherited or result from a random mutation.

For example, micrognathia can occur as part of Stickler syndrome or Treacher Collins syndrome (TCS).3 A protruding chin may also be a symptom of acromegaly or gigantism, which involve abnormal bone growth.6

Jaw misalignment may also occur in children born with a cleft lip and palate.

Childhood Habits

Certain repeated behaviors during childhood can affect jaw development. A child born with a standard jaw can still develop alignment problems as they grow.

Some habits that may lead to poor jaw development include:4, 5, 7

  • Mouth breathing — use of the mouth rather than the nose for breathing can contribute to a long, narrow midface (upper jaw) and an open bite
  • Thumb sucking or tongue thrusting — constant pressure from a finger or tongue can affect the pattern of jaw growth and lead to teeth malocclusion
  • Prolonged bottle feeding or excessive pacifier use — like thumb sucking, these can affect the way the jaw and teeth grow
  • Poor nutrition — a soft diet high in processed foods can lead to smaller, weaker jaw bone and muscle tissue

Other Causes

Altered or abnormal jaw alignment may have other causes, including:

  • Chronic nasal congestion during childhood, which can lead to mouth breathing8
  • An injury to the jaw
  • A tumor in the mouth or jaw

How to Tell if Your Jaw is Misaligned

Many people have misaligned teeth or jaws that still fall within a normal, healthy range. Very few people, if any, have perfectly symmetrical faces, but a slight difference in the jawline is usually not noticeable.

image 15

A truly misaligned jaw is more likely to be visually noticeable and have other symptoms, such as:

A noticeably asymmetrical jawline may not present with any other symptoms. But it can still be a major cosmetic concern that affects a person’s quality of life.

How to Fix a Misaligned Jaw

There are several kinds of treatment for jaw misalignment, which may be combined as part of a comprehensive plan. Your specific treatment needs will depend on your age, the severity of your jaw issues, and your symptoms.

Orthodontic Treatment

Because misaligned jaws often come along with crooked and/or crowded teeth, orthodontic (teeth-correcting) treatment can be an essential step. Orthodontic treatment methods include:

Braces can put enough pressure on teeth to correct severe misalignment.

Clear aligners are an excellent alternative for less severe cases, while more severe cases may require braces and headgear (in children) or corrective surgery (for adults).

Orthognathic Surgery

Sometimes the asymmetry or mismatch in a person’s jaws can’t be treated without surgery. This is especially likely if the person is an adult.

Children and their bones are still growing, which helps with treatments involving orthodontic devices. Once someone is fully grown, orthodontic treatment can still help, but surgery may be necessary to correct the problem fully.

Orthognathic (jaw-correcting) surgery may include:

  • Osteotomy — a controlled fracture in the upper jaw (maxilla) or lower jaw (mandible) that allows the bone to reshape
  • Genioplasty — also known as chin reduction or chin augmentation, this procedure changes the shape of the chin
  • TMJ surgery — procedures intended to correct problems with the jaw joint by replacing or removing damaged tissue, such as arthroscopy and arthrocentesis

A dental professional may perform surgery on its own if a person’s jaw issues are primarily cosmetic. But in many cases, teeth misalignment and other issues are also involved. In these cases, the dental professional might combine surgery with orthodontics and other treatments to provide the most predictable results.

Physical Therapy

Physical therapy can treat certain jaw issues. This includes exercises to strengthen and increase the range of motion of your jaw. Massages and relaxation techniques may also help.

Your dentist, orthodontist, or oral surgeon may also recommend developing better habits to reinforce the results of your treatment. These may include:

  • Breathing through your nose rather than through your mouth
  • Maintaining good tongue posture
  • Maintaining healthy back and neck posture
  • Reducing bruxism or unconscious jaw clenching

Your dentist may advise you to avoid tough foods that strain your jaw. On the other hand, you might be encouraged to use chewing to strengthen your jaw muscles. Talk to your dentist or other professional about what to practice and avoid.

Tips for Managing Jaw Pain

Because an uneven jaw or TMJ problem can cause pain, it’s important to alleviate the strain on your jaw until you get proper treatment. This may mean:

  • Avoiding tough or sticky foods, including chewing gum
  • Occasionally applying heat to relax your jaw
  • Gently massaging the area
  • Reducing unconscious habits like bruxism and mouth breathing
  • If your jaw issues are on one side, not sleeping on that side

Summary

While few people have perfectly even or symmetrical jaws, some have jaw misalignments that cause health problems or severely affect their self-image.

Misaligned jaws can result from genetics, childhood habits, injuries, and other factors. Fortunately, orthodontic treatment, surgery, and/or improved lifestyle habits can usually correct jaw misalignment.

Frequently Asked Questions (FAQs)

Can a misaligned jaw be corrected?

Uneven jaws can be corrected with the right treatment. Oral and maxillofacial surgeons specialize in treating jaw issues. Orthodontic treatment can address any teeth alignment problems that may be involved.

Can a misaligned jaw fix itself?

A minor jawbone misalignment may fix itself. But in general, a skeletal (bone) imbalance needs deliberate dental care. Surgery, lifestyle changes, and/or orthodontic treatment may all be necessary.

Are there alternatives to surgery for an uneven jaw?

Proper tongue posture, physical therapy, and massages may help with jaw problems. However, an underlying skeletal imbalance will require surgery for proper correction.

What happens if I don’t treat my jaw misalignment?

If you have a misaligned jaw and don’t receive treatment, the problem may worsen over time. Your facial and jaw muscles will compensate for what’s missing or out of balance, and you may end up with worn enamel, persistent pain, and trouble chewing and sleeping.

Is it normal to have an asymmetrical face?

Nearly everyone has some degree of asymmetry in their face. If you created a mirror image of each side of someone’s face, you would notice a difference between the two sides.

Slight asymmetry usually isn’t serious. The human body is naturally slightly asymmetrical. People generally have one dominant hand, the right lung is generally wider and shorter than the left lung, and so on.

Last updated on December 28, 2022
9 Sources Cited
Last updated on December 28, 2022
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Sun, R., et al. "Identification and Functional Studies of MYO1H for Mandibular Prognathism." Journal of Dental Research, 2018.
  2. Zabrina, Stephanie, et al. "Genetic and epigenetic aspects of class III malocclusion with mandibular prognathism phenotypes." AIP Conference Proceedings, 2021.
  3. Motch Perrine, Susan M. et al. "Phenotypes, Developmental Basis, and Genetics of Pierre Robin Complex." Journal of Developmental Biology, 2020.
  4. Jefferson, Yosh. “Mouth breathing: adverse effects on facial growth, health, academics, and behavior.” General dentistry, 2010.
  5. Valcheva, Zornitsa, et al. "The Role of Mouth Breathing on Dentition Development and Formation." Journal of IMAB, 2018.
  6. Acromegaly.” Genetic and Rare Diseases Information Center.
  7. Lieberman, Daniel E., et al. "Effects of food processing on masticatory strain and craniofacial growth in a retrognathic face." Journal of Human Evolution, 2004.
  8. Trabalon, Marie, and Benoist Schaal. “It takes a mouth to eat and a nose to breathe: abnormal oral respiration affects neonates' oral competence and systemic adaptation.” International journal of pediatrics, 2012.
  9. Ingervall, Bengt, and Elias Bitsanis. "A pilot study of the effect of masticatory muscle training on facial growth in long-face children." European Journal of Orthodontics, 1987.
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