My face/mouth has changed significantly in the last 10 years (teeth, mostly I believe). Any suggestions? (photos)

In the photo you posted(4 years ago), your smile and teeth looked great.  That is a lot of change in 4 years, but that is the look I think should be restored and will give your face/smile/teeth the look you want.  Your teeth appeared larger and whiter, and you will not be able to achieve those results with Insisalign/braces.  I I feel the best way to accomplish this would be with either porcelain veneers or dental bonding.Whichever you choose, the first step should be to get a smile preview.  For porcelain veneers, this can be done by having your dentist have his dental laboratory create a diagnostic wax up over a model of your existing teeth.  Using an impression of this waxup and some temporary veneer material, your dentist can transfer a preview of your smile directly to your mouth.  For dental bonding, a preview can be created by applying special bonding material(I recommendProVeneers) directly to your teeth to give you a Smile Preview Veneer.  Using either of these techniques will give you an inexpensive way to make sure you will be able to get the results you want before committing to the more expensive final treatment.  Dr. Gary BraunsteinEncinitas/Carlsbad California

Dear Jean Seaberg1979,Thank you for posting your question on Real Self. I will do my best to answer your questions with the information provided. It appears from your photos that your arches are narrowing as you mature.  It is the natural migration of teeth, and in many instances, you will also see lower crowding. In most women, a narrow smile seems to age them. Wider arches would bring back a more youthful appearance. There red are different options to achieve this. It appears in your photos that you have very beautiful teeth. I recommend Invisalign to widen your smile. I have seen patients who were thinking of plastic surgery change their minds after widening their smile. If this interests you, I recommend scheduling a consultation with an orthodontist. Another option ion is to schedule a consultation with a cosmetic dentist and possibly improving your smile with veneers.I hope that this helps and good luck!Best,Dr. Jenn

Faces will naturally change over time - a little.  Physiologic forces, chewing, breathing, swallowing and other habits we develop with our orofacial muscles can cause the face to change dramatically over time.  People with sleep apnea and breathing problems can see great changes in their appearance over time.  You should get full records to at least capture where you are in time right now and then perhaps a very thoughtful airway savy dentist can examine and help identify what may be happening in your case and what can be done to reverse it.