midlines

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#1 Post by **sadpanda** » Tue Sep 07, 2010 6:02 pm

Do orthos correct midlines only according to your teeth or by your facial features too? When I see my top midline compared to the bottom, it doesn't look that bad, but when I look at my teeth midline compared to where my nose is, it's so off. My teeth look super lopsided which makes my braces look lopsided too. Any ideas?

#2 Post by **BracedVeryLate** » Tue Sep 07, 2010 7:00 pm

I specifically asked my ortho to align my top midline with the middle of my top lip. It was off by at least 2mm and to me it was very noticeable.

#3 Post by **mexicanlatino19** » Tue Sep 07, 2010 8:52 pm

my upper and lower teeth do not match

similar to photo here
http://www.drvandenberg.com/art/MidlinesOffCenter01.png

my jaw is shifted sideways, does braces correct this or i need jaw surgery?

#4 Post by **drrick** » Wed Sep 08, 2010 8:32 am

It is often impossible to align the upper and lower midline to eachother d/t asymettry issues (no one is truly symmetrical)

Docs have different oinions on this but my personal feeling is if I have to chose btwn upper and lower midlines being dead on but both off center to the face and the upper centered to the face but u/l midlines off I will choose Upper Midline to the Face.

Having said that a fair amount of research has been done on this and they have found that the 'average person' does not consider a facial and dental midline discreapancy less attractive until it is off by 2mm and then only about 1/2 found it less attractive. They have re-done this study and now found that it can be off by 4mm before the avg person finds it less attractive. (Think Tom Cruise)

One caveat -- the midline must still be straight up and down and not cantes.

#5 Post by **VA5** » Wed Sep 08, 2010 12:11 pm

drrick wrote:It is often impossible to align the upper and lower midline to eachother d/t asymettry issues (no one is truly symmetrical)

Docs have different oinions on this but my personal feeling is if I have to chose btwn upper and lower midlines being dead on but both off center to the face and the upper centered to the face but u/l midlines off I will choose Upper Midline to the Face.

Having said that a fair amount of research has been done on this and they have found that the 'average person' does not consider a facial and dental midline discreapancy less attractive until it is off by 2mm and then only about 1/2 found it less attractive. They have re-done this study and now found that it can be off by 4mm before the avg person finds it less attractive. (Think Tom Cruise)

One caveat -- the midline must still be straight up and down and not cantes.

Dr. Rick,
How does one fix a crooked midline (cantes??). My top and bottom are too far right (at least a couple mm) but they are faily aligned. I feel they both need to move over a tad, but the big thing I'm noticing as I said is the top middle is slightly slanted. I will even go so far as to tell you that the middle, right next to the gum, is practically in the center.. but it's the slant of the front two teeth that make the midline look off. Is this something my ortho can correct and how do they un-slant the teeth??

Thanks!

#6 Post by **drrick** » Wed Sep 08, 2010 2:28 pm

It depends if it is the teeth themselves or the whole jaw that is canted.

This is a kinf of have to see you type scenario.

#7 Post by **VA5** » Wed Sep 08, 2010 6:41 pm

drrick wrote:It depends if it is the teeth themselves or the whole jaw that is canted.

This is a kinf of have to see you type scenario.

Thanks Dr. Rick. I will ask my ortho when I see him again. But I was curious... there IS something you can do about canted midlines whether it's the teeth themselves or the whole jaw? Can you tell me what you would do in each scenario?

#8 Post by **drrick** » Thu Sep 09, 2010 8:58 am

If your JAW is canted then elastics, TADS, or surgery are a couple treatment strategy. It depsnds on teh nature and severity of the cant.
If your TEETH are canted this is usually taken care of by the archwires and making space in appropriate areas (often with elastics added in as well)

This is a gross oversimplification.

#9 Post by **Flaka** » Sat Sep 11, 2010 9:07 pm

Dr. rick, what if braces and elastics caused the cant? I didn't have canted teeth, jaw and now I do since having elastics put on early on the treatment. Now 28 months later my smile/ teeth still have a cant.

Can this be fixed?

#10 Post by **drrick** » Sun Sep 12, 2010 9:32 am

the GREAT majority of times the cant WAS there but was not noticed.
Most pts will not notice a cant when there are other issues (crowding, spacing, overbite, etc)

In any event it can usually be corrected by the means I mentioned above.