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By Daljit Gill BDS, BSc, MSc, FDS RCS, M.Orth, F.Orth RCS (Eng)
Consultant Orthodontist, UCLH Eastman Dental Hospital, London UK.
Many patients present for treatment because they are unhappy about the protrusion of the upper incisor teeth. Orthodontists term this type of bite a Class II division I incisor malocclusion.
Upper incisor protrusion is extremely common within Caucasian populations (15-20%).
The majority of cases of upper incisor protrusion are paradoxically due to retrusion of the lower jaw. When the lower jaw is retrusive, the lower incisor teeth and the lower lip are also relatively set back giving the impression that the upper teeth are sticking forwards. This is particularly the case when the lower lip fails to cover the upper incisors. Sometimes the lower lip catches behind the upper incisors pushing them forwards even further. This is termed a lip trap.
In other cases, upper incisor protrusion may be caused by a digit sucking habit. Here the presence of a digit (thumb or finger) pushing forwards on the upper incisors results in their protrusion relative to the lower incisor teeth.
As well as having cosmetic concerns, upper incisor protrusion also increases the chance of damaging the upper incisor teeth following any form of traumatic injury to the face. In fact the risk of trauma parallels the severity of upper incisor protrusion.
There are several ways of treating upper incisor protrusion depending on the cause. The first step is always to stop a digit sucking habit if this is contributory. Following this there are many options:
There are really only two ways of treating upper incisor protrusion in adults: