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Braces

Do crooked teeth cause facial asymmetry?

08/15/2006

Question:

I`m 24 years old, i have crowded teeth, and my mouth looks crooked in relation to the rest of my face, but my lips by themselves look symmetrical. My lower jaw is deviated to the left, the midline of my chin is quite off to my left side. I had braces three years ago only on my top teeth to bring one of my canines down cause it was potruted (i have the same condition on my lower teeth) and bothered me when i smiled, they aren`t perfectly aligned, one of my incissors overlaps the other a little bit, but they do look a lot better than they did, but the midline of my top teeth doesn`t align perfectly to the bridge of my nose. The thing is that the midline of my lower teeth and chin is very off, and i`m wondering if this is because of my lower teeth being crooked, no crossbite is apparent, however it seems to me that they don`t fit like they should. I`ve been analizing photos of myself when i was younger, and it seems to have been gradual, i didn`t always have a crooked face, it seems to have started getting crooked when i was 12 or so. My jaw sometimes pops when i yawn and sometimes makes a grinding noise when i eat. Could my asymmetry be caused by my teeth, or does it sound more like it`s my entire jaw? Can it be fixed by getting braces so that my jaw has to sit at its proper alignment point? if so, will my cheeks and lips adapt to the new position or will my top-right lip look droopy?

Answer:

Well, you pose some interesting questions. One thing that caught my attention was that your asymmetry seemed to stem from when you were twelve. This would coincide with what we would call the start of the growth spurt, and it could be that one side of your lower jaw grew more than the other.  If this happened it could account for the lack of symmetry. This can be easily diagnosed by a radiograph, sometimes called a sub-mental vertex view.  It can be taken by an orthodontist by pointing the cone perpendicular to the plane of the lower jaw. 
 
Yes, it can often be corrected by orthodontics (braces) but if very severe might require a combination of orthodontics and surgery.  In any event, you should consult with a trained orthodontic specialist.  If you need the name of one in your area, contact the American Association of Orthodontists at 1-800-424-2841.

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Response by:

Walter C Buchsieb, DDS, MS Walter C Buchsieb, DDS, MS
Professor Emeritus - Clinical, Associate of Dentistry
College of Dentistry
The Ohio State University