My smile has progressively gotten more crooked, can this be fixed?

I'm sorry to hear about the concerns with your smile. A progressively crooked smile can be distressing, and it's understandable that you want to find a solution. There are several potential causes for this issue, and addressing it effectively will depend on identifying the underlying cause. Here are some possibilities and steps you can take:

Potential Causes
1. Dental Issues:
- Misalignment of teeth or jaw.
- Dental work that might have changed the balance of your smile.

2. Muscular or Nerve Issues:
- Facial nerve issues, such as Bell's palsy or other nerve damage.
- Muscle imbalances or weakness on one side of the face.

3. Genetic Factors:
- Natural asymmetry that has become more pronounced over time.

4. Other Medical Conditions:
- Conditions affecting the nervous system or muscles.

Steps to Take
1. Consult a Dentist:
- A dentist can evaluate if there are any dental or orthodontic issues contributing to the asymmetry. They might recommend braces, aligners, or other dental treatments if misalignment is found.

2. See a Neurologist:
- If you suspect nerve or muscle issues, a neurologist can perform tests to determine if there is any nerve damage or other neurological conditions affecting your facial muscles.

3. Visit a Facial Plastic Surgeon:
- They can assess if surgical or non-surgical options might help improve symmetry. This could include procedures that address muscle or structural issues.

4. Physical Therapy:
- If muscle imbalance is the cause, a physical therapist specializing in facial muscles might be able to provide exercises to improve muscle function and symmetry.

5. Botox Consultation:
- While the nurse mentioned that Botox might not help much, it can sometimes be used to address muscle imbalances. Consulting with a specialist who has experience in using Botox for facial asymmetry might provide more insight.

Treatment Options
- Orthodontic Treatment: Braces or clear aligners to correct dental misalignment.
- Surgical Interventions: Procedures to correct structural issues.
- Physical Therapy: Exercises to strengthen and balance facial muscles.
- Botox or Fillers: To relax overactive muscles or add volume to areas that need it.

It's important to start with a thorough evaluation from healthcare professionals, including a dentist, neurologist, and possibly a facial plastic surgeon. Each specialist can provide insights into whether the issue is dental, neurological, or structural, and recommend appropriate treatments. With the right diagnosis and treatment plan, there is a good chance that the asymmetry can be improved.