A midline shift in your teeth is more than an aesthetic issue. It can cause complications with your jaw and wear down your teeth faster.

Have you ever struggled with an uneven smile or a bite that feels incorrect?, If the answer is yes, you may have a midline shift. A midline shift is when the imaginary straight line that runs down your upper and lower front teeth does not align correctly.

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Why you should be concerned

People tend to brush off a midline shift as a cosmetic problem. When it's actually a genuine medical concern that can directly affect your quality of life. An untreated midline shift can lead to strain on your jaw, issues with your bite, and wear down your teeth. It is important to get the appropriate treatment as soon as possible. Clear aligners are an excellent choice for treating a midline shift.

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What is a midline shift?

If your mouth is healthy, your upper and lower teeth should align correctly with the center of your face. Any deviations from this, such as gaps between teeth, lopsided smiles, and crowding, are likely a case of a midline shift. Overbites and other alignment issues can happen at the same time as a midline shift, and can contribute to it worsening. When looking at overbites vs normal teeth suffering from a midline shift, you can see that the mouth affected by an overbite adds onto the effects of a midline shift (complications, bite issues, etc).

Causes of midline shift

A close-up image of crowded, misaligned teeth

There are many reasons why you could be suffering from a midline shift. These can range from genetic traits to being the result of habits you had as a child. Here is a breakdown of a few of the causes:

  • Genetics and development: Certain genetic traits that you can inherit from your parents can be a factor. These traits can predispose you to a midline shift by affecting your jaw and tooth alignment. You can inherit complications like jaw asymmetry, having too many or too few teeth, facial asymmetry, and various genetic mutations.

  • Dental trauma: A bad injury or accident can change the position of your teeth and alter the structure of your jaw entirely. Injuries that knock out teeth or apply severe pressure to your jaw can ruin alignment and lead to a midline shift.

  • Early baby tooth loss: Losing your baby teeth earlier than you should, particularly your molars and canines, can cause your teeth to drift in your early years, which can cause misalignment.

  • Missing teeth: Having gaps in your mouth from missing teeth can make other teeth shift out of place over time. This can lead to a midline shift.

  • Jaw misalignment: Having a jaw with structural issues that is out of position is another common cause for midline shift. Under and Overbites, for example, can disrupt the entire alignment of your mouth if not corrected.

  • Thumb sucking and oral habits: Sustained poor oral habits can cause a midline shift. Thumb sucking, for example, creates pressure that can push your front teeth outward and cause misalignment. Mouthbreathing can also cause a midline shift by changing the way your tongue is positioned and can interfere with jaw growth.

  • Tooth size irregularities: Abnormally small or large teeth can create many complications. They can throw off the balance inside your mouth and cause a case of midline shift.

  • Facial asymmetry: Whether it's something you were born with or developed due to an injury, facial asymmetry can be a direct cause for a midline shift.

  • Tooth decay and gum disease: Tooth decay (cavities) and receding or infected gums can lead to tooth loss, which in turn causes a midline shift.

Problems associated with midline shift

There are many oral issues caused directly by a midline shift. A midline shift can cause serious complications with your bite. This will lead to issues with chewing and eating, and even malnutrition. Jaw issues are also a result of a midline shift. Over time, an untreated case can stress your jaw joint and cause it to deteriorate and weaken. TMJ (Temporomandibular Joint Dysfunction) can be worsened by a midline shift, causing pain in your jaw and ears. Uneven Tooth wear is also a common side effect of a midline shift. Having excessive pressure on certain teeth can damage them much faster and cause cavities and fractures as well.

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Treatment options for midline shift

A dentist treating a patient inside the clinic

Thankfully, there are loads of effective treatment options out there for midline shift. From braces to numerous orthodontic appliances, here are some of them:

  • Braces: Braces can apply the correct amount of force to realign your teeth with your dental midline over time. It may be an expensive and inconvenient treatment, but it has been proven to be effective in correcting a midline shift.

  • Clear aligners: Clear aligners are arguably the least intrusive way to deal with midline shift. They aren't obvious like braces, and also apply a steady amount of force over the duration of the treatment to create a healthy midline. Easily the most convenient method of treating misalignment issues.

  • Orthodontic appliances: Many orthodontic appliances can treat teeth that are not aligned. Rubber bands, coil springs, and other dental accessories can help cure a midline shift.

  • Comprehensive treatment: Lastly, for severe cases, a comprehensive treatment plan might be needed, combining braces, aligners, and accessories to treat a bad case. For a comprehensive treatment plan, it is best practice to consult with your dentist beforehand to ensure that you are going about it in the safest and effective way.

What can a dentist do for your midline shift?

Firstly, a dentist can properly diagnose a midline shift and accurately determine the root cause of it. Once the root cause has been determined, a dentist can administer a variety of specific treatments to help. There are all of the standard ones, like braces and clear aligners, and more advanced ones:

  • Hyrax expanders: A Hyrax expander can widen your upper jaw by applying the right amount of pressure on your teeth. This will create enough space for your teeth to shift back into the right spot.

  • Tooth Removal: A dentist can also remove particular problematic teeth to create space for the others to shift into the correct position.

  • Surgery: In particularly bad cases, such as ones where there is a structural issue with the jaw itself or when other methods are not effective, a dentist can perform surgery to properly align your mouth.

Conclusion

It's apparent that a midline shift is much more than a simple issue with your appearance. It is a legitimately concerning issue within your mouth and can lead to some disruptive issues with your health. An untreated midline shift can damage your ability to function normally by making you constantly uncomfortable.

It can also create more serious oral health issues, such as cavities and jaw damage. Do not take a midline shift lightly. Getting a thorough examination done by an orthodontist is an important step to take to ensure that you can prevent serious complications.

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Frequently asked questions

faqs
A midline shift in your teeth can have many causes. Some of them are: genetics, dental trauma, early baby tooth loss, missing teeth, and bad oral habits.
A midline shift in your teeth indicates that your teeth are not lining up with the imaginary vertical line on your face.
You can correct midline misalignment by using braces, clear aligners, orthodontic appliances, or a comprehensive treatment that includes all of them.
A deviation of one to two millimeters is considered acceptable by most dentists. Above that is usually where concern arises.
A regular retainer won't be able to help you with a midline shift. An adjusted one may be able to assist by applying gentle pressure over time.
No, a dental midline shift is not an emergency, but it can cause further complications down the line that turn into an emergency if not addressed in a timely manner.

References

National Institute of Health: https://pmc.ncbi.nlm.nih.gov/articles/PMC11242880/

The Open Dentistry Journal: https://opendentistryjournal.com/VOLUME/15/PAGE/405/FULLTEXT/