What Can I Do About my Crooked Mouth/lips/smile? (photO)

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.

You have wonderful questions, and really what you need is a practitioner who can manage both TMJ issues AND your cosmetic concerns. I'd start by addressing your jaw pain first. There are not a ton of successful TMJ dentists out there. Many general dentists don't want to treat these kind of issues.Your smile and lip display may change once the pain decreases. The other preliminary approach my patients have found helpful is using DSD- Digital Smile Design. With that we assess with video how your face is moving and then exactly where your smile should show. We often can just lay a simulation right over your teeth now so that we can both see what the new look will be and make sure that it addresses all of your concerns BEFORE you start any Smile Makeover or veneer treatments.Rarely, you may get some medical coverage for treatment of your TMJ, but in today's medical world with large deductibles, that's not often a real benefit. Many dental plans often have some coverage for Orthodontics or Invisalign, so "maybe" some coverage there.IF you've been really feeling self-conscious about this, you will be surprised at how you feel when it's the way you enjoy. I've seen patients get promotions because of their new level of confidence. You are young, the benefits of changing this will apply for decades!So address the TMJ pain first, then get a great cosmetic simulation with video to truly see what your path will be.

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.