By Dr. John White
Facial asymmetry is more common than you might think. In fact, it is the norm. More than half of the population has a lack of facial symmetry, with approximately 60 percent having minor and 15-20 percent moderate to severe asymmetry.
Just one look at movie star Tom Cruise or jazz musician Harry Connick Jr., however, and you can see that having asymmetrical features doesn’t necessarily distract from your appearance.
Ideally, the upper six front teeth from side to side should be parallel to the pupil of your eyes. Since this is not always the case, orthodontics can straighten the teeth and make compensatory changes in the bite to find a balance between the best looking smile and most harmonious bite.
A misaligned jaw is more than just an aesthetic consideration. While it is important to note that people with perfectly straight teeth can have jaw problems and those with really crooked teeth may have no problems with their jaw, you have to examine more than just the teeth—including bone and temporomandibular joint (TMJ)—when looking at asymmetry.
Most often, asymmetry is not genetic but occurs while the jaw is developing, like when permanent teeth come in to replace baby teeth and the child cannot find a quality bite. As this occurs, the child habitually moves his or her mouth to bite comfortably and the other teeth shift to support that position.
Also, if a child chronically holds his or her jaw, for example, to the left because of a cross bite where the top and bottom jaws do not fit properly, one side of the jaw will elongate to adapt, which can lead to facial asymmetry.
Most of these asymmetries on young patients can be corrected with interceptive orthodontics (or later with jaw surgery) if the patient’s teeth are mature and have stopped growing.
As an orthodontist and dentofacial orthopedist, I review on a case-by-case basis how teeth are aligned and if the jaw is properly functioning, so straight teeth and healthy bites are both a significant part of my treatment goals.