The midline of our teeth simply refers to the space between the two center teeth up top and the two center teeth on the bottom, as they should line up. A misaligned midline simply means that they do not line up or are off-center on the face. The midline should bisect the nose and line up with the center of the space between the eyebrows. Midline misalignment is often a simple aesthetic issue but sometimes, more severe problems can arise.
What causes a misaligned midline?
There are quite a few factors that can lead to midline misalignment including lifestyle habits and some medical conditions. Sometimes, adult teeth simply erupt out of alignment in childhood. When a patient's teeth grow abnormally and do not follow spacing established with baby teeth, the teeth can become crowded and result in misalignment. Even childhood habits can contribute to misalignment in adulthood, such as prolonged thumb-sucking or pacifier use.
Other issues that can cause a misaligned midline include missing teeth and jaw misalignment. When your bite is aligned properly, the upper teeth close slightly over the lower teeth. If the jaw is misaligned, a patient may have an underbite, open bite, or cross bite. An underbite is when your lower teeth stick out beyond the upper teeth. A crossbite is a type of lateral misalignment and both arches of teeth tilt inward toward the gum instead of sitting straight in the jaw.
Additionally, when a tooth is missing or has been extracted, the remaining teeth often shift together to fill the space, causing misalignment.
Treating Midline Misalignment
Orthodontic therapy and porcelain veneers are the most common treatment methods used to correct a misaligned midline. Orthodontic treatment can be provided with either traditional metal braces or clear aligners. Both options use gentle pressure to push, pull, and rotate the teeth into alignment.
Braces use metal brackets and an archwire on the top and bottom teeth. The arch wire is progressively tightened to shift the teeth. Clear aligners often get results more quickly than braces. Clear aligners use clear plastic trays instead of an arch wire that are changed every two weeks or so to gradually shift the teeth. After orthodontic treatment is complete, it is important to wear your retainers as directed to keep your teeth in position.
Another treatment option for some is porcelain dental veneers. Veneers are a thin, porcelain material that is placed over each tooth to create a new, confidence giving smile. Veneers are most often used for patients that do not like the shape of their teeth or the appearance of their smile. Since the porcelain can accommodate the desired shape and can be tinted to provide the desired brightness of the teeth, it is a widely used material in dental restoration.
Midline misalignment is not always just an aesthetic issue, it can greatly impact your oral health. If you have misalignment issues, speak with your dentist to see what options they offer and what might be best for you. Your dentist may offer orthodontic treatment in office but if they do not, they will be able to refer you to an orthodontist that they trust.