BACKGROUND The relationship between molar occlusion and chewing patterns was examined in subjects with laterally deviated mandibles. METHODS Twenty-three patients with mandibular deviation from the midline (4 mm or more) and skeletal Class I (0° ≤ANB ≤4°) were divided into 2 groups: normal bite and crossbite. The chewing pattern was classified as normal, reversed, or crossover. RESULTS The normal bite group had a normal chewing pattern on the affected side 100% of the time and a reversed chewing pattern on the affected and unaffected sides 0% and 7.2% of the time, respectively. Additionally, the normal bite group showed no evidence of a crossover chewing pattern and also had significantly less axial inclination of the mandibular teeth on the affected side compared with the crossbite group; lingual inclination was also evident. The crossbite group had a normal chewing pattern on the affected and unaffected sides 0% and 55.6% of the time, respectively, and reversed and crossover chewing patterns on the affected side 55.6% and 44.4% of the time, respectively. CONCLUSIONS A normal chewing pattern tends to result in lingual axial inclination of the mandibular molars on the affected side, as well as a more consistent chewing pattern.