The difference between dental and skeletal problems
Orthodontic problems fall roughly into two groups. In dental problems the jaws are in harmony with each other, but the teeth are in the wrong position, tilted or crowded. In skeletal problems there is a mismatch in the size or position of the upper and lower jaws. In many people both occur together.
This distinction directly affects the choice of treatment: dental problems can mostly be corrected with clear aligners or braces, while skeletal problems may need appliances during growth and, in adults, sometimes combined planning of orthodontics and jaw surgery.
Why do these problems matter?
- Cleaning: Crowded teeth are harder to clean between; the risk of decay and gum disease can rise.
- Wear and fracture: A faulty bite can overload and wear down certain teeth.
- Gums: Deep bite and crossbite can contribute to gum recession.
- Chewing and speech: Problems such as an open bite can affect biting and the pronunciation of some sounds.
- Injury: Protruding front teeth break more easily in falls and knocks.
How is the problem diagnosed?
Diagnosis uses an intraoral and facial examination, a panoramic and if needed a cephalometric X-ray, photos and an intraoral 3D scan. These records help determine whether the problem is dental or skeletal and which treatment will be suitable. For details, see the first orthodontic examination page.
On the pages below we cover each problem separately. If you are not sure which group you fall into, this can be assessed together at the examination using your records.