I'm looking for a Hollywood smile, but I have a bad midline shift. Is there anyway to completely fix this?

Question

I'll do anything! I have had braces before, although my teeth are now straight, the are no longer symmetrical with my nose. Would there be anything possible to correct this ? Thanks !

Daniel H. Chong, DDS · Answer

You have beautiful smile already, but if you are concerned with shifted midline, it can be improved with restorations. I say improvement because if dental midline cannot be corrected with bodily movement with orthodontics or surgery to coincide with facial midline, the only thing we can do with restoration is to fool the eyes to mask midline discrepancy.When dental midline is canted to either left or right, it is noticeable right away. When dental midline is shifted but perpendicular to horizontal plane it is less noticeable (literature is available on this subject).Just looking at your picture there is a slight cant on the midline. I usually use inter-pupillary line to determine horizontal occlusal plane. Consult with a prosthodontist near you and ask for treatment options.

Ace Jovanovski, DMD · Answer

First: You have great looking teeth!! Congratulations!Finding: Midline is off by 1/2 a tooth to the patient's right. Why?1. Skeletal base/skeletal growth asymmetry. The jaws can grow disproportionately, meaning one side can grow more than another, causing a shift of the midline towards the side that grows less. 2. Early tooth loss.As a child, there may have been a tooth that was lost prematurely, or may have never developed, subsequently the new adult teeth will erupt into the empty space, causing a shift to the affected side. 3. Tooth size discrepancy.More difficult to judge from the photo... the size (width) of the two central incisors don't match, the central incisor on the patient's left (tooth #9) looks smaller than the right( #8). Notice edges of the teeth, the V-shaped space formed by the curved proximal surfaces of adjacent teeth is known as the embrasure. The embrasures on the patient's left are larger than on the right.Potential solutions:Orthodontics: Can partially, or fully correct midline, Depending on radiographic analysis (cephalometric and CBCT). Interproximal stripping (IPS) is selective adjustment of the tooth surfaces in between each tooth. By creating space in between selective teeth (in essence creating a gap) the orthodontist can move the teeth towards the empty spaces, minimizing or fully correcting the midline problem.Orthognathic surgery: Involves significant double jaw surgery, most likely is done in tandem with a 2nd round of braces...Depending on radiographic analysis (cephalometric and CBCT) . 3-dimensional imaging would also more than likely show that you have a deviated septum and or nasal tubernate, due to limited space on the patient's right (Consult an ENT for further evaluation)Restorative: Ceramic Veneers or Crowns can move the midline, PARTIALLY, to the patient's left, by approximately 1-2 mm. You would still have a shift to the right by about 2-4 mm, although it would be less than current position.  Remember, as always, Get a consultation with your local friendly prosthodontist specialist for a comprehensive evaluation.Hope that helps!Dr. Ace

Ramzi Matar, DDS · Answer

I assume the orthodontist was unable to correct the midline shift any more that this? assume that is correct then you are left with 2 options to correct the of center midline.  First would be jaw surgery, Second would be the options of placing veneers on several of the upper teeth and correct it with veneers (restorative treatment.)  I will say my ex[perience is that with such a slight mid line shift it's probably no noticable to anyone but yourself people in the dental industry.  Tom Cruise famously has a much more severe midline shift that he has not corrected thus far.  Consult a local cosmetic dentist to find out more.

Mark Weiser, DDS · Answer

If, in fact, your jaws are not properly positioned, then Dr. Jamal's suggest is an option.  I have fixed a couple of these orthodontically (only moving the teeth, not the jaws).  I would need a full set of standard photos taken by a dental office who makes ortho photos on a regular basis. Or see a local orthodontist for a consultation.

Majid Jamali, DMD · Answer

Correction could be done with jaw surgery. Mostly likely upper and lower jaw. Please consult a surgeon.

I'm looking for a Hollywood smile, but I have a bad midline shift. Is there anyway to completely fix this?

Answers (7)

Answer: Midline corrections

Answer: Midline corrections

Answer: Jaw

Answer: Jaw

Recommended reading

Everything you need to know about Smile Makeover

Our mission is to create a world where every investment in modern beauty is Worth It.

I'm looking for a Hollywood smile, but I have a bad midline shift. Is there anyway to completely fix this?

Answers (7)

Answer: Midline corrections

Answer: Midline corrections

Answer: Jaw

Answer: Jaw

Browse related questions

Recommended reading

Everything you need to know about Smile Makeover

Our mission is to create a world where every investment in modern beauty is Worth It.