My daughter was born with a "crooked smile". It is noticeable when she speaks but most noticeable when she smiles, opens her mouth wide or frowns. I was told it could be a possible fetal stroke or stroke at birth, weak / undeveloped muscle / tendon, but no other explanation was given. Neurological, and heart problems (I was told there could be a connection) were ruled out as an infant. I was wondering what the best way correct her smile is, especially looking for a permanent solution.
Are There Any Permanent Ways to Fix a "Crooked Smile"? (photo)
Doctor Answers 4
A Crooked Smile caused by a lip asymmetry could be improved with Oral Myology
A Crooked Smile caused by a lip asymmetry could be improved with Oral Myology. I agree with others who have talked about the lower lip being the problem and likely is a neurological problem. Ruling out a neurologic solution, however, your best approach would be to seek the services of an Oral Myologist (also known by other names such as Myofunctional Therapist, or Orofacial Myologist) who specialize in working one on one with the patient to retrain any muscle activity that is not ideal, such as your daughter's lower lip asymmetry. Don't get discouraged as answers to this type of thing can be difficult to find.
Crooked smile is a muscle or nerve issue
Your daughter seems to be quite young. Like 7-9 yr old. Her teeth are normal for her age. What you were told seems correct. The muscle that moves the lower lip corner down and back seems weak. This could be a muscle issue or a nerve issue(nerve that tells that muscle to contract). You are right that it is less noticable when no teeth show. You should rule out a habit.
You mentioned she was born this way. So if she had this as a baby, then it rules out an aquired habit. You would need a pediatric neurologist evaluation to diagnose. Does she also have asymetries when raising eye brows? Puckering lips like a kiss? squinting eyes? This would help narrow down if the issue is with a nerve trunk or with a single nerve or muscle.
I'm not sure if anything can be done for it. It the neurologist doesn't offer a solution, then later in life she may consider botox on the opposite side to reduce the movement and even things out a bit.
Can we fix crooked smile?
Yes many optioins are available consider orthodontics, maybe invisalign or veneers or crowns. Good Luck
Kevin Coughlin DMD, MBA, MAGD CEO Baystate Dental PC
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Permanent Way to Fix a Crooked Smile
It appears from your photos that your daughter's problem is with her lower lip, not with her teeth. Have her evaluated by her Pediatrician, who might want to get a neurological consultation.