Malocclusion In Children: Which Bite Problems Fix Themselves

Written By: Logan Grover, Content Writer

Reviewed By: Dr. Alison Grover, Board-Certified Diplomate Pediatric Dentist

Last Reviewed: October 21, 2026

Malocclusion in children means the upper and lower teeth don't meet the way they should when your child bites down. Most kids have at least a mild version. A Swedish study that followed 277 children from age 3 to age 11.5 found malocclusion in 71% of them at age 3. Open bites in that group fell from 22% at age 3 to 1% by 11.5. Others, like deep bites, showed up later. So the useful question is which kind your child has, and whether it needs care now or can wait. The type of bite problem decides that more than your child's age does.

What Is Malocclusion in Children?

Malocclusion in children is any mismatch in how a child's upper and lower teeth or jaws line up when they close. It includes crossbites, open bites, deep bites, overjet, underbites, crowding and spacing. Some cases come from inherited jaw and tooth size. Others come from habits like pacifier use or from losing baby teeth early.

How common is it? A 2020 global review in the European Journal of Paediatric Dentistry put worldwide prevalence at 56%, and 53% in the Americas. Treat that as a rough number. The studies it pooled varied so much that the confidence range ran from 11% to 99%.

The number parents should care about is smaller. In the Swedish study, 22% of the children showed a severe or extreme need for orthodontic treatment. The rest had a moderate need, a small one, or none.

Types of Malocclusion in Kids

Pediatric dentists sort malocclusion by what the teeth do when your child bites down. The 7 common types are below, with what each one tends to do as your child grows.

Bite type	What you'd see	Common causes	What it tends to do	When it's usually treated
Open bite	Front teeth don't touch when the back teeth close	Pacifier or thumb sucking	Often closes once the habit stops. 22.0% at age 3, 1.1% at 11.5	Stop the habit by 36 months. Treat if it stays open
Back (posterior) crossbite	Upper back teeth sit inside the lower back teeth	Long pacifier use, narrow upper jaw	Fell from 12.3% at age 3 to 4.0% at 11.5	Right away if the jaw slides sideways to close
Front (anterior) crossbite	Upper front teeth sit behind the lower front teeth	A tipped tooth, or a jaw size difference	Depends on the cause	As soon as it's found, if there's room to move the tooth
Overjet, or "buck teeth"	Upper front teeth stick out past the lower ones	Inherited jaw size, thumb sucking	Class II bites (often with overjet) fell from 19.5% at age 3 to 7.6% at 11.5	Often in the teen years
Deep bite	Upper front teeth cover more of the lower front teeth than normal	Inherited jaw growth	Rose from 5.8% at age 3 to 18.4% at 11.5	Usually once the permanent teeth are in
Crowding	Teeth overlap or come in twisted	Teeth too big for the jaw, baby teeth lost early	Becomes more common in permanent teeth	Watched in baby teeth. Treated as adult teeth come in
Spacing	Gaps between teeth	Normal in baby teeth	Gaps become less common in permanent teeth	Rarely treated in baby teeth

Percentages come from Dimberg and colleagues, The Angle Orthodontist, 2015. Crowding and spacing trends come from Lombardo and colleagues, 2020.

The 3 Classes of Malocclusion

Dentists classify bites with Edward Angle's system, which has 3 classes based on how the upper and lower first molars meet. You may see charts online that list Class IV, V and VI. Those aren't part of Angle's system.

Class	How the molars meet	What parents notice
Class I	Molars meet in the normal position	Jaws line up. Problems are crowding, spacing or single teeth out of place
Class II	Lower molar sits behind the upper molar	Upper front teeth stick out, or a deep bite
Class III	Lower molar sits ahead of the upper molar	Lower front teeth sit in front of the upper ones

In young kids, the class can change. In the Swedish study, Class II bites dropped from 19.5% at age 3 to 7.6% at 11.5, and Class III bites dropped from 5.1% at age 3 to 1.8% at age 7.

Can Malocclusion Correct Itself in Children?

Yes, some types often do, especially open bites and back crossbites in toddlers once a sucking habit stops. Others, like deep bites and crowding, tend to show up or get worse as the permanent teeth come in.

This is where the evidence disagrees with common advice online. Finding a malocclusion in a 3-year-old isn't a reason to start treatment. In the Swedish study, open bites dropped from 22.0% at age 3 to 8.9% at age 7 and 1.1% at 11.5. Over the same years, sucking habits fell from 82% of the kids to 0.4%. The habits, allergies and breathing problems recorded at age 3 had no link to malocclusion at 11.5.

That matches the American Academy of Pediatric Dentistry's (AAPD) 2024 pacifier policy, which says an open bite from pacifier use improves once the pacifier is gone before age 3. Weaning off pacifier and thumb habits before that birthday is the step parents control.

But bites move in both directions. Deep bites rose from 5.8% to 18.4% over the same years. A clean bite at age 3 doesn't promise a clean bite at 11. That's the case for checking the bite at every 6-month visit, not once.

One caution. This is 1 study of 277 kids in Sweden. It's the clearest long-term look we found at how bites change in the same children over time, and it isn't the last word.

Bite Problems That Need Early Treatment

Based on AAPD guidance, 3 situations are worth acting on before all the permanent teeth are in: a back crossbite that makes the jaw slide sideways, a front crossbite with room to move the tooth, and a sucking habit that runs past 36 months.

The table sorts the rest by what the evidence supports.

Act now	Watch at each 6-month visit	Usually involves an orthodontist or surgeon
Back crossbite where the jaw shifts to one side to close	Open bite in a child under 3 who still uses a pacifier	Lower jaw growing well ahead of the upper jaw
Front crossbite with room to move the tooth	Spacing in baby teeth	Jaw size differences that may need surgery after growth ends
Thumb or pacifier habit past 36 months	Mild crowding in baby teeth
	Deep bite or overjet before the permanent teeth are in

The jaw shift is the case the AAPD says not to wait on. Its guidance on the developing bite says a crossbite that shifts the jaw should be corrected as soon as possible to avoid jaw joint problems and uneven growth. For upper teeth that stick out, the same guidance says 1 phase or 2 phases of treatment both work. That's the reason Phase 1 can often wait for that bite. For a lower jaw that outgrows the upper jaw, the AAPD says surgery combined with orthodontics may be the best option for some children, which usually means jaw surgery once growth is done.

What Causes Malocclusion in Kids?

Inherited jaw and tooth size are the causes you can't change. The ones you can change are sucking habits, early loss of baby teeth, and cavities in baby molars.

Habits come first. The AAPD links pacifier use past 18 months to open bites, back crossbites and Class II bites, and recommends stopping by 36 months.

Early tooth loss comes next. When a baby molar comes out years early, the teeth beside it can drift into the gap and block the adult tooth. A decayed baby molar that can be saved keeps holding that space. At Mini Miners, that can mean a white crown on a back molar or a Hall crown, which goes on with no drilling and no numbing shot. The AAPD notes that evidence on whether space maintainers prevent malocclusion is lacking.

Mouth breathing gets blamed often online. In the Swedish study, breathing problems at age 3 had no link to malocclusion at 11.5. One study doesn't settle it, so bring it up at your child's next checkup if they snore or breathe through their mouth.

Bite Care for Kids at Mini Miners

Mini Miners sees children from their first birthday and offers Phase 1 orthodontics in its Erie office. The first visit is recommended by the first birthday, or within 6 months after the first tooth comes in, with checkups every 6 months after that. Regular visits from age 1 mean a change in the bite can be compared against earlier visits instead of judged from 1 look.

X-rays are low-radiation digital X-rays, taken in the treatment room with a handheld unit, so your child stays in the chair and keeps watching their movie. The American Association of Orthodontists recommends an orthodontic check by age 7, when baby and adult teeth are both in the mouth.

When a bite needs early care, Mini Miners offers Phase 1 orthodontics in Erie, usually between ages 6 and 10. The problems it treats include front crossbites, back crossbites, severe crowding and oral habits. Every treatment room is plumbed for nitrous oxide, which the practice offers to help anxious kids stay relaxed while braces go on.

Malocclusion Treatment for Children in 2026

Treatment depends on the bite type. It ranges from breaking a habit to a removable appliance, clear aligners or braces. Phase 1 treatment at Mini Miners typically runs 9 to 18 months.

Treatment	Used for	What to expect
Habit help	Open bite or crossbite from a pacifier or thumb	Goal is no habit by 36 months. Mini Miners lists oral habits among the Phase 1 problems it treats
Removable appliance	Simple crossbites	Part of Phase 1 at Mini Miners, 9 to 18 months
Clear aligners for kids	Alignment problems while baby and adult teeth are mixed	Mini Miners uses Invisalign aligners designed for younger patients
Braces	Crowding, overjet and deep bite in permanent teeth	19.9 months on average for full braces. Mini Miners offers kid-friendly braces for Phase 1
Jaw surgery	Large jaw size differences	After growth ends

The braces figure comes from a 2016 review of 22 studies by Tsichlaki and colleagues in the American Journal of Orthodontics and Dentofacial Orthopedics. Mini Miners says most children feel minimal discomfort with Phase 1 appliances, and any soreness is mild and temporary. Phase 1 fixes the problem that can't wait. It doesn't promise your child skips braces later, and some kids still need a second phase as teenagers.

When Should Your Child's Bite Get Checked?

The AAPD recommends a first dental exam by age 1, and the AAO recommends an orthodontic check by age 7. Don't wait for either milestone if you see any of these:

• The jaw slides to one side when your child closes

• The front teeth don't touch when the back teeth are together

• The lower front teeth sit in front of the upper ones

• Thumb or pacifier use past age 3

• Upper front teeth stick out far enough that the lips don't close over them

• Trouble biting into food, or new speech changes

Malocclusion in children is common, and in the Swedish study most toddler open bites were gone by age 11. The bite problems that don't fade on their own are the ones worth catching early. If you've noticed any of these signs, call (303) 500-3202 or text (720) 734-5890 to book a visit at Mini Miners Pediatric Dentistry, 61 Erie Pkwy, Unit 101, in Erie.

FAQs

Is malocclusion in children normal?

Yes. In a Swedish study of 277 children, 71% had some form of malocclusion at age 3 and 71% at age 11.5. Far fewer needed treatment: 22% showed a severe or extreme need.

Can malocclusion in children be fixed without braces?

Sometimes. The AAPD says an open bite from pacifier use improves once the pacifier is gone before age 3. Mini Miners treats simple crossbites with a removable appliance, and its Phase 1 treatment typically runs 9 to 18 months.

At what age should a child's bite be checked?

The AAPD recommends a first dental exam by age 1, and the AAO recommends an orthodontic check by age 7. Mini Miners recommends a first visit by the first birthday and checkups every 6 months after that, so changes in the bite can be compared from visit to visit.

Does a pacifier cause malocclusion?

Long pacifier use is linked to open bites, back crossbites and Class II bites. The AAPD recommends stopping by 36 months, and an open bite from pacifier use improves when the pacifier goes before age 3.

How long does malocclusion treatment take?

Phase 1 treatment at Mini Miners typically lasts 9 to 18 months. Full braces average 19.9 months, based on a 2016 review of 22 studies. Some kids who have Phase 1 still need a second phase as teenagers.

Is malocclusion genetic?

Partly. Jaw size and tooth size run in families, so mention a parent's underbite or crowding at your child's visit. Habits, early loss of baby teeth and cavities in baby molars add to what genetics starts.

Will my child need braces after Phase 1?

Possibly. Phase 1 fixes the problem that can't wait, like a crossbite that shifts the jaw. Some children still need a second phase as teenagers once all the permanent teeth are in.