Smile Getting Worse: How Can I Reverse the Effects of Aging?

Question

I used to love my smile but it's really changing for the worse. Gummy looking and I'm really sensitive to temperatures. Besides yellowing I also see visible wear. What can be done???

Brent Moelleken, MD · Answer

Many patients attribute their aging mouth appearance to their teeth alone.  However, changes in the lip tissues and the loss of fat and drooping around the mouth play a huge role as well.
The lips and area around the mouth age in predictable and reversible ways.  There are several temporary and more permanent fixes for the aging smile.
Temporary fixes:
1.  Juvederm to the lips, to the marionette areas.  This enhances the lost volume and fills in "nooks and crannies" that result from volume loss
2.  Botox (careful now!) to the frown muscle.  This must be very judiciously placed, and can help reduce the action of a main frown muscle, the DAO (depressor anguli oris).
More permanent fixes:
1.  LiveFill or fat injection to the lips and marionette areas.  LiveFill (the patient's own tissues, unprocessed) may give longer lasting results than fat injection.
2.  Division of the DAO (depressor anguli oris) muscle.  The frowning muscle can be divided, resulting in a subtle uptick in the corner of the mouth.  This is often requested in patients who notice that they are frowning more over time
3.  Reduction in jowls and tissues that droop and collect around the mouth with minilift or facelift techniques
4.  Lip-lifts- Often the upper lip becomes very long, obscuring the upper teeth and allowing the lower teeth to show, the "old person's smile".  In suitable patients, the lip-nose distance can be reduced by a gull wing upper lip lift, literally removing tissues from the natural lower nasal contours and restoring the smaller lip-nose distance of youth
5.  Corner Lip lifts- In the right patients, downgoing upper corners of the lip can be elevated by careful removal of corner upper lip tissues.  Great care must obviously be taken to preserve the normal borders of the lip that make lip tissue so unique.

Elly Tehrani, DMD, MSD · Answer

You will need a comprehensive dental exam.  This might require referral to dental specialists, to evaluate your bite (occlusion), the status of your periodontal health.  Grinding could cause wear of your teeth, and as the result teeth might look shorter.  This could be corrected by rebuilding the lost tooth structure using dental crowns or even dental composite and  bonding materials. 

	I am not sure if you have gum recession or not? since you make a comment about gummy smile.  If recession is present, you will have sensitivity to cold. Gum recession could be corrected by Gum graft procedures.

	you should see your general dentist.  In collaboration with dental specialists, he/ she will address your concerns ....

	A picture of the areas of your concern would have been helpful.

Scott Young, DDS · Answer

The loss of length to the teeth from wear and tear of grinding can give our smiles an aged look.  You may be a great candidate for a smile rejuvenation. A comprehensive exam would need to be completed to determine the cause and amount of tooth structure that you have lost.  If the tooth loss is extensive you may need to have your bite altered to address the grinding and make room for the new porcelain veneers.  This process would take several visits to find a comfortable position for your new bite.  I would look for a dentist that is trained in Neuromuscular Dentistry to work with you.  Once the bite is in a comfortable position, porcelain veneers or crowns would be placed on all of the teeth to restore the bite and improve the aesthetics.  By going through this process the face is slightly lengthened and the patients many times look 10-15 years younger with their new smiles.  It is difficult to explain this process in detail without having you in the office.  Set up a consult with a well trained cosmetic dentist and have him/her go over your options.  Good luck.

Peter Joseph, DMD · Answer

IF you have a lot of wear, it is likely you will need to address your wear issues. Sometimes wear also causes changes to your gum line in addition to the loss of tooth length. In those circumstances a periodontist will work with your restorative doctor to determine if gum needs to be removed or added to help you get your cosmetics and function back.

Wendy S. Spektor, DDS · Answer

Talk to your dentist and ask if they are the ones who can treat you.  Typically you need to see a Prosthodontist who specializes in overall dental rehabs so you receive the correct care.  Do your research and find somewhere that you feel comfortable because you will be investing in your smile and need a team effort.  To begin, you will need to let the dentist evaluate your bite and smile and go from there.  Study models and radiographs will be a must as well as healthy gums.  If things look fine, look into a dentist who does Botox and Filler and you can love your smile again with modifications that are simple!

Smile Getting Worse: How Can I Reverse the Effects of Aging?

Answers (6)

Answer: Improving your smile while improving your oral health

Answer: Improving your smile while improving your oral health

Answer: Aging Does Affect Your Smile

Answer: Aging Does Affect Your Smile

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Smile Getting Worse: How Can I Reverse the Effects of Aging?

Answers (6)

Answer: Improving your smile while improving your oral health

Answer: Improving your smile while improving your oral health

Answer: Aging Does Affect Your Smile

Answer: Aging Does Affect Your Smile

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Everything you need to know about Gum Lift

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