For years I have been self-conscious about the appearance of my mouth. My lips are asymmetrical on the top and bottom and I have empty space on either side of my teeth when I smile. I also have a popping jaw that can be very painful. My question is are these things related and what kind of specialist do I need to see? Should I get braces or jaw/facial surgery? Would this be something that insurance might cover because of the jaw pain? Tell me what you think, thank you. ~G
What Can I Do About my Crooked Mouth/lips/smile? (photO)
Doctor Answers 3
Smile symmetry issues
It seems that a major concern is the muscle pull exerted by the zygomaticus minor muscle on the left side. It seems to have a larger pull on your soft tissue (lips, cheek) and in doing so causing the off balance smile. An experienced clinician with the use of a few units of botox could reduce the muscular pull on that side and even things out. Mid face injections are tricky and need experience so your entire smile does not "drop". Causes are varied and could be related to developmental issue, trauma, etc...The lower lip on the right side is higher than on the left so maybe relaxing the DAO (depressor anguli otis) on the opposite side could keep the left lip from dropping too low? All of these treatments are treating the muscles and are relatively new. The TMJ is another issue and the training of the clinician whether neuromuscular or centric relation is really only a concern as to if they are good at their diagnosis. both ways work and both have draw backs. I only get worried when someone says only one way works which is not true! many treatment modalities are available and many are successful. the key is the DDS performing the therapy and their education level.
Crooked smile and lips?
In most cases in my experience ins. will not cover... The diagnosis is based on what the cause is from? Nerve damage? bad bite? Bell's Palsy? when you know the cause you will be able to decide on a course of care. Good luck
Kevin Coughlin DMD, MBA, MAGD CEO Baystate Dental PC
It appears that you have several issues. #1 is a TMJ problem (clicking jaw). I would recommend seeing a Neuromuscular Dentist to first address the TMJ issue, and to find the proper position for your teeth. Then, you would be referred to a Neuromuscular Orthodontist, who would move your teeth into the pre-determined position which relieves yor TMJ symptoms. Do not believe any dentist/orthodontist who just tells you that braces will cure your TMJ. Only a Neuromuscularly trained dentist can actually cure your TMJ FIRST, and then move your teeth.
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