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Common Cases

Malocclusion, or an improper bite, can be due to abnormalities in the teeth or jaws. Issues can run the gamut from a mild case of crowding to a severe crossbite. Dr. Chan can give you an expert diagnosis and customize treatment to fit your particular situation for excellent results. While every smile is different, these are the most common cases we see and examples of how we may treat them depending on the complexity of the problem.



When the lower jaw sticks out past the upper jaw, it’s known as an underbite. This can happen if the jaws don’t grow at the same rate. Early treatment can be beneficial because if an underbite is severe, it can cause a host of problems including sleep apnea and difficulties with chewing and speaking.

The use of special appliances to advance the jaw and upper teeth followed by braces or, sometimes, Invisalign, can work wonders if we start treatment while the patient is still growing. Adults may require orthognathic surgery, which is just a big word for jaw surgery, paired with orthodontic treatment to see the results they want.

Upper Front Teeth Protrusion

This is doctor speak for when the top front teeth stick out. It can be because they’re positioned too far forward or the lower teeth are too far back. While it might make you dislike the appearance of your smile, it also puts the teeth at greater risk for injury.

Traditional metal braces, ceramic braces, self-ligating braces and Invisalign can usually do the trick.


A crossbite is when the upper teeth are behind the lower teeth either in the back (posterior crossbite) or the front (anterior crossbite). People tend to compensate by moving the jaw to the side or forward, which can cause permanent changes to their bone or facial structure. It’s usually genetic or caused by habits including thumb sucking and nail biting.

Anterior crossbites are treated with braces or Invisalign. Posterior crossbites sometimes require us to expand the upper jaw in combination with braces or Invisalign.


Overbite, also known as overjet, is characterized by upper front teeth that stick out too far past the bottom front teeth. It makes your top teeth more susceptible to injury, is sometimes associated with a “gummy” smile and can cause excessive wear of the enamel.

Mild and moderate overbites respond to traditional metal braces, ceramic braces, self-ligating braces and, sometimes, Invisalign. Severe cases could require appliances that move the jaws into their correct positions along with braces.
Common Open Bite


When a patient has an openbite, their upper and lower front teeth don’t meet when the jaws are closed which can seriously affect their ability to chew. Habits like tongue thrusting and thumb sucking as well as genetics could be the culprits behind it. This is a case that’s best addressed early, particularly if it’s due to a skeletal irregularity, so we can avoid surgery.

Treatment options for an openbite vary greatly and really depend on whether it’s a skeletal issue and how severe the problem is. If we diagnose it while the jaw is still growing, we can use appliances followed by braces or Invisalign. To treat adults, jaw surgery combined with orthodontic treatment is sometimes the best route.


When there isn’t enough space in the jaw to accommodate all of your teeth, crowding occurs. Teeth might protrude or overlap, which makes them harder to clean and may cause you to feel self-conscious about your smile. Crowding could be due to a problem with the tooth to jaw size relationship or the primary teeth falling out too early.

For your average case, metal braces, ceramic braces, self-ligating braces or Invisalign alone will suffice. Sometimes, we’ll also need to expand the jaw or recontour the teeth to make them the right size. We try to avoid extractions unless there are no other options.


Spacing is the opposite of crowding and entails gaps between the teeth. In these cases, there’s too much room in the jaw and the teeth can’t fill all of the space. It can be thanks to genetics, narrow teeth or even habits like thumb sucking. Spacing is associated with gum disease and bone loss so it’s important to address.

We use braces or Invisalign to close the gaps. In severe cases, when orthodontic treatment alone won’t eliminate the extra space, veneers can make the teeth wider.

Want to Benefit From an Orthodontist’s Expertise?

You don’t need a referral from a dentist to see Dr. Chan. We have locations in Bothell, Mill Creek and Monroe, Washington and Juneau, Alaska. Simply contact the office of your choice and we’ll schedule you for a complimentary visit. It’s that easy!
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