James Otten, DDS

Your problem is not an uncommon one as any dental procedure, including orthodontics, can trigger an existing problem that perhaps wasn't identified or fully evaluated before treatment. Clicking and popping are signs and symptoms that the cartilage disc is damaged and partially displaced. What has likely happened is that one(likely) or both (not likely) became completely displaced as the aligners changed the bite you had become accustomed to. It happens even in the best of circumstances and it's not easy or predictable to unlock  these discs in this situation but it can sometimes be done. As the previous doctor advised, first inform your orthodontist and if they don't know how to address this you'll need to find someone who can and the sooner the better or the lock is likely to persist. Most often we will want to also image these problems with both CT scans and MRI so we know the status of both the bone and the cartilage and then can provide a prognosis for treatment.

It's hard to appreciate the amount of sloping or what we call a "canted" smile because we can't see your eyes or other parts of your face that we reference to assess this further but it's safe to say that most often this is a skeletal problem or one related to the development of the bones of the jaws. It is possible that this could be a genetic trait or the result of a jaw joint injury that shortened your lower jaw on the right side and the upper jaw followed in its development. The bottom line is that this is not something that Invisalign or any orthodontic technique alone is likely to correct. Seek advice from a practitioner who understands TMJ development and orthodontics to get the best advice.

I will echo some others who rightfully say that you need far more information to assess this problem correctly as there are likely many influences in your condition. What seems to be obvious from your description that you have had skeletal changes that are most likely the result of changes at the level of the TMJ's. The question is are the joints themselves stable? The answer to that question is the foundation of how to actually treat "TMD". Orthodontics are a tool to align teeth in harmony with a stable joint and skeletal base, not the other way around.

Not necessarily, and in fact this approach may complicate your overall health should you have any tongue space challenges and breathing restriction (which by your photos is highly likely). Bicuspid extraction, while still popular among some practitioners because it's an easy way to make space, often only considers the alignment of teeth not necessarily how that impacts the TM joints and airway by making the arches smaller and understanding how they got that way to begin with. There are many other options to treat the vast majority of cases like yours without extraction and you should at least hear those options from an informed practitioner.

Hi there, it's hard to tell why you dont show your teeth. It may not be the length of the teeth but possibly the length and mobility of your lip. You need to find someone to really examine all parts of the system that are involved in the esthetics and figure out this question before trying anything more. Did your teeth used to show before they were restored and did your dentist design your teeth in an intermediate prototype in your mouth before completing the final restorations?