Is Misaligned Midline Normal?
The midline of an arch of teeth is the line between the two upper front teeth and the two lower front teeth. When the teeth are aligned properly, this line of division evenly bisects the nose and is symmetrically aligned with the space between the eyes and eyebrows. There are a few different reasons that this proportion can shift out of place, and this shift results in a misaligned midline. A misaligned midline affects the appearance of the smile, even when the shift in symmetry is subtle, and it can also lead to potentially severe dental complications if left untreated. Thankfully, a misaligned midline is relatively common and can be treated with a few different effective methods, depending on the cause of the misalignment and the preferences of the patient.
Midline misalignment can be very subtle, extremely noticeable, or anywhere in between. Even if the appearance of your misaligned midline doesn’t bother you, it’s a good idea to consult with an orthodontist to make sure it won’t cause complications down the line. The primary concern that arises with midline misalignment is the efficacy of the bite, and the resulting disproportionate wear on the teeth. If a shift in the midline is caused by an issue with the alignment of the jaw, the result can be a disorder called bruxism, which is characterized by the chronic grinding of the teeth; when the teeth are misaligned, the effects of imbalanced tooth grinding can result in excessive damage to teeth in a localized area, making these teeth more vulnerable to decay, breakage, and infection.
There are several reasons that the midline can be misaligned. Some of the more common reasons include missing teeth, which create room for the teeth to shift out of alignment; the teeth can be missing because of tooth decay, gum disease, or for genetic reasons. People with oversized or undersized teeth may also face issues with the alignment of their teeth, including the midline, and people who lose their primary teeth prematurely are more prone to bite issues like midline misalignment. Damaging habits like prolonged thumbsucking or pacifier use can cause bite issues that include overbite, open bite, and crossbite, each of which can come with midline misalignment, and trauma to the mouth or teeth can also affect dental alignment and the position of the bite. As you can see, midline shift is common and can be caused by a number of different factors, and there are also a number of ways to treat the issue. While it may not pose an immediate threat to the oral health, leaving a misaligned midline untreated is likely to lead to issues and should be avoided. Treatment will depend on the cause and severity of your misaligned midline, whether there are other issues with dental alignment, and your own goals, needs, and budget. The more common treatment methods include braces, invisible dental aligners like Invisalign, orthodontic mechanisms called Hyrax expanders that expand the upper jaw, extraction of crowded or too-large teeth, and cosmetic treatments like dental veneers. If midline misalignment is severe and is caused by structural issues, orthodontic surgery may be recommended, though most orthodontists will try other treatment solutions before resorting to surgery.