Typically, a dentist uncovers the nature of a patient’s malocclusion through a dental examination that includes a review of the patient’s dental history. Typically, the dentist will retract the patient’s cheek outward and ask the patient to bite down normally. This allows the dentist to see if the patient’s bite is correct. In most cases, malocclusion can be spotted by the time a patient’s permanent teeth begin to erupt, which may take place as early as 6 or 7 years of age.

If the dentist suspects malocclusion, the patient will be referred to an orthodontist. This is a dentist who specializes in diagnosing and treating misaligned teeth and jaws. Malocclusion is the most common reason for referrals to orthodontists.

The orthodontist also will perform an inspection of the patient’s teeth and mouth to further pinpoint the nature of a patient’s malocclusion. Dental x-rays will be taken. A panoramic x-ray captures an image of all the upper and lower teeth in biting position, and a lateral x-ray of the entire head (cephalometric x-ray) captures the relationship of the teeth and jaws to the rest of the face. 

Impressions of the teeth are taken by having the patient bite down on a soft rubbery material that hardens. These impressions are used to create a plaster model that duplicates the patient’s bite. This model can be used as a baseline reference against which the patient’s progress is monitored. Photographs of the patient’s face and teeth also may be taken to trace how treatment changes the person’s facial appearance.

After these steps have been taken and all relevant information has been gathered, a treatment plan will be formulated.