Is Midline Misalignment a Problem?
It is actually quite incredible how symmetrical the human body is. People in general have good symmetry, but no one is perfect. For example, perhaps one eyebrow is a bit higher than the other or the feet are a half-size different. It is actually more common than you might think to have one or more features that are asymmetrical.
The patient may even have a smile that is slightly uncentered. A condition called midline misalignment can actually cause this. There are fortunately treatment options which can help correct this and restore a patient’s smile.
A dividing line is present on the face which is located between the top and bottom teeth. This line is called the midline and if you visualize a line directly down the center of the face from forehead to chin, it should pass the middle of the nose and go right between the front teeth. When this fails to exist, it suggests that the teeth have shifted beyond the midpoint due to midline misalignment. Common causes for midline misalignment are summarized below.
Premature Tooth Loss
The primary or baby teeth play a critical role in helping children eat, speak, and perform other important tasks. The baby teeth also creat space for the eruption of the permanent teeth. When a child loses their primary teeth too early, it can cause issues with the permanent teeth where they shift into the empty space, ultimately resulting in the midline moving.
Lifestyle Habits
It is quite common for young children to use a pacifier or suck their thumb. The permanent teeth start to erupt when children are in elementary school. When children continue to suck their thumb or use a pacifier with permanent teeth, it can cause various orthodontic issues including a misaligned midline. The constant sucking pressure can cause the teeth to slowly shift.
Missing Teeth
Various issues such as trauma, accidents, decay, and gum disease can all result in the loss of a tooth. It is also possible for an adult tooth to be impacted or completely fail to erupt. The open space can allow for the teeth to shift into the gap.
Overcrowding
Patients with teeth that are overly crowded, have large gaps, are too big or small, or have other issues, often experience spacing problems including midline misalignment.
Crossbite
A crossbite is a bite issue where the teeth do not fit together properly. The upper teeth actually fit inside lower teeth, rather than sitting on the outside of the lower jaw as they should. A deviated midline may also suggest the patient has a posterior crossbite where the top back teeth slant inwards or fit inside the bottom teeth.
While a minor midline shift may not be overly concerning, teeth which are noticeably out of alignment should be taken seriously. Patients should follow up with their dentist to discuss the cause and review their treatment options. The dentist will complete a thorough evaluation to determine the cause of the shift.
Minor shifts can typically be treated using an orthodontic treatment such as braces or Invisalign. Crossbites or other bite issues may require an orthodontic treatment along with rubber bands or an appliance to accomplish the desired alignment. When the patient has a severe crossbite, the dental professional may opt to use palatal expanders to realign the teeth.
A misaligned midline may seem like a simple cosmetic issue, but it can cause serious issues which should be treated in a timely manner.
Most patients cannot realistically achieve absolutely perfect symmetry. Patients who are looking to restore the alignment of their smile should follow up with a dental professional to discuss treatment options.