The midline of your teeth is the center of the upper and lower arches and usually bisects the nose and lines up with the center of the space between the eyebrows. A misaligned midline can cause some patients to feel self-conscious but is actually pretty normal among adult patients. Most of the time, misalignment is more of an aesthetic issue but depending on the severity of misalignment, other problems can result including malocclusion, tooth fracture, bruxism, and TMJ issues.
Midline misalignment most often happens when permanent teeth come in crooked but can also be caused by missing teeth, dental trauma, jaw misalignment, or teeth that are either too small or too large for the space.
There are many different types of malocclusion, the technical term for a bad bite. When the upper and lower teeth do not line up correctly like with an overbite or underbite, it can lead to shifting teeth, difficulty eating, and midline misalignment.
Additionally, bruxism can cause midline misalignment and is the unconscious clenching and/or grinding of the teeth in our sleep or even during the day. Bruxism can also lead to shifting teeth, dental decay, and may even cause chips and cracks in the teeth.
Midline misalignment is often a matter of appearance, but it can lead to much bigger problems in the future if it is not corrected. Fortunately, there are a few options for fixing a misaligned midline.
What are the treatment options for a misaligned midline?
Orthodontic Therapy
Braces or clear aligners are the most common treatment for a misaligned midline. Both types of orthodontic therapy can be used to fix the midline and straighten any teeth that have shifted out of place. Traditional braces use metal brackets and a metal arch wire to gently apply pressure to push and pull the teeth into alignment. Clear aligners use clear plastic trays that fit over the entire arch of the teeth and progressively, with each new set of trays, shift them into place.
Porcelain Veneers
Porcelain veneers are another way to fix a misaligned midline and to improve your smile altogether. Veneers are placed on the front surface of the front teeth, the ones that show when you smile. They are made of thin porcelain that is permanently cemented to the front of the teeth and can be used instead of orthodontic treatment when appropriate. Veneers have the added benefit of correcting any aesthetic issue that you would like to change about your smile. They can make your teeth appear larger and even whiter.
A misaligned midline is common but thankfully, is often relatively easy to fix. Some patients may need to have work done on their jaw, but that is for severe cases. Your dentist can discuss treatment options and may even offer clear aligner therapy in the office but if they do not or believe that braces would be the better option, they will refer you to an orthodontist for further evaluation.
Additionally, if veneers are the treatment you choose, your dentist will likely be able to provide that treatment as well!