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

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???

Doctor Answers 6

Cosmetic smile and lip rejuvenation

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.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 reviews

Tooth sesnsitivity to temperature change

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. 

Elly Tehrani, DMD, MSD
Toronto Periodontist
5.0 out of 5 stars 37 reviews

Improving your smile while improving your oral health

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.

Peter Joseph, DMD
Baltimore Dentist

Aging Does Affect Your Smile

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!

Wendy S. Spektor, DDS
Bellevue Dentist
5.0 out of 5 stars 3 reviews

Smile Makeover For An Aging Smile

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.

Scott Young, DDS
Houston Dentist
5.0 out of 5 stars 13 reviews

You may need to have your bite restored to an ideal position

If you are at least in your late forties, you probably show signs of tooth wear in your mouth. The signs we most often see are chipping of the front teeth, large facets on either the upper or lower teeth, recession areas at the gum line of teeth in the upper and lower arches, especially the eye teeth and the teeth just behind them, sensitivity to cold, and or a definite “meshing” of the teeth when you slide your jaw either from side to side or back and forth.

When these signs are present, there’s also a strain on the muscles that control your biting and chewing. When these muscles are under strain, it can cause the nerves that govern these muscles to give you symptoms that, while typical for this condition, are very different from the ones in the paragraph above.

Patients who exhibit these secondary symptoms need to have their bite restored to an ideal position because there is no way to measure a non-ideal position. That is accomplished by either just adjusting the bite using computerized measurements, or restoring or redoing many of the old worn or fractured teeth or restorations in the back and placing porcelain veneers on the chipped or broken teeth in the front with the use of our computerized measurements.

These secondary symptoms can vary from person to person. You may have one or several or all of the symptoms. They range from head or facial pain, jaw clenching at night, neck pain, difficulty in speaking or swallowing, limited mouth opening, a jaw that locks, headaches, tingling in the fingers, to eye strain. These symptoms can be mild to severe and change back and forth depending on the time of day or recent activity. Typically people who have these symptoms go from medical doctor to medical doctor for a cure, often receiving medication that only masks the problem, but never cures it. Or just getting a “pat on the shoulder” with the words, “You’ll just have to learn to live with this.” Sometimes these symptoms can be so severe that they can completely take over your life.

Ronald Rosenblatt, DDS
Beverly Hills Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.