Is Misaligned Midline Normal?
Beautiful smiles are noticeable and make a big impact. Patients often desire a beautiful smile that they can be proud of. There are numerous dental problems which can negatively impact the appearance of a patient’s smile. Just a slight shift in how the front teeth are aligned can affect the teeth. Misalignment can cause bite issues, a midline shift, and other oral health problems.
The midline of the teeth is essentially a dividing line between the teeth in the upper and lower jaw. Ideally, the teeth midline should go through the center of the nose and space right between the eyebrows. Midline shifts or a misaligned midline can vary and range from virtually unnoticeable to quite severe.
The appearance of a teeth midline shift is not always overly concerning, but there are other problems which can arise. The alignment of the teeth can directly impact the patient’s bite. In addition, a misaligned midline can cause issues such as uneven wear, grinding, decay, and damage to the teeth.
Causes
There are various things which can cause a misaligned midline or midline shift. Some of the most common causes are summarized below:
1. Accident, injury, or trauma
2. Early loss of baby teeth
3. Macrodontia or large teeth
4. Microdontia or small teeth
5. Misaligned jaw
6. Missing teeth
7. Thumb sucking or bad oral habits
A teeth midline shift or misaligned midline is relatively common. The recommended treatment will vary based on how severe the issue is, the patient’s goals, oral health, and cost. Various treatments can be used to correct a misaligned midline which are summarized below.
Invisalign
Invisalign is a great treatment option for the correction of a mild to moderate midline shift. A deviated midline combined with a crossbite or other bite issues can benefit from Invisalign. The treatment can be combined with other dental appliances in order to resolve the issue. Invisalign uses clear aligner trays which are very conspicuous are barely noticeable. The trays should be removed for eating, drinking, and cleaning the teeth.
Braces
Braces are another effective solution for repairing midline misalignment. They are especially effective when patients also have complex issues such as a crossbite. When braces are combined with elastics or other appliances, they can be used in skeletal realignment. One of the limitations associated with braces is that they are quite bulky, visible, and can be uncomfortable.
Hyrax expander
A Hyrax expander is another solution which can be used to treat a midline shift. The expander is connected to the teeth and placed in the roof of the mouth, where it expands the upper jaw. It works by creating additional space and allowing for the teeth to shift into the correct location. Hyrax expanders are usually worn for nine months or less.
Extraction
Another solution for treating a misaligned midline is to extract one or more teeth. The removal of the tooth can create additional space in the mouth, allowing for the remaining teeth to move into place. This can also aid in eliminating gaps in the mouth. The dentist may opt to use tooth extraction along with other treatments such as braces or Invisalign to achieve optimal results.
Surgery may be required in cases of a severely misaligned midline or when there is a structural issue. Surgery and extraction are typically used as a last resort when other solutions fail or are not feasible.
Patients with a misaligned midline or midline shift contact their dentist. The dentist can complete a thorough examination, review treatment options, and discuss any questions.