Is Misaligned Midline Normal?

Patients are constantly working to achieve a beautiful smile. Various dental issues can impact the patient’s smile. Even a minor shift in the alignment of the front teeth can negatively impact the appearance the teeth. This can impact the patient’s bite and result in serious oral health complications such as a midline shift. This article will discuss midline shift or misaligned midline such as a definition of the condition, causes, and treatment options.


The teeth midline is a dividing line which exists between the teeth in the upper and lower jaw. When looking in a mirror, the teeth midline shift should bisect the nose and space between the eyebrows. A midline shift can have asymmetry ranging from barely noticeable or rather prominent.


While the appearance of a teeth midline shift may not be overly concerning, there can be problematic consequences associated with the condition. It is possible for the alignment of the teeth to impact the bite. The teeth midline shift can cause problems including grinding, uneven wear, cavities, cracks, and other issues.



Primary causes of dental midline shift can vary. Common causes for dental midline issues include the following:

  • Bad habits such as thumb sucking
  • Missing teeth
  • Large teeth or macrodontia
  • Small teeth or microdontia
  • Missing teeth
  • Baby teeth which are fall out too early
  • Jaw misalignment
  • Trauma or accidents



While a teeth midline shift is a relatively common condition, the ideal treatment can vary for patients depending on the severity of their issue, goals, budget etc. There are fortunately various treatment options which can be used to correct dental midline misalignment. Common treatments are summarized below.



Braces are an effective method used to repair midline misalignment. They can be especially helpful when the issue is combed with more complex problems like a crossbite. Braces can also be used in skeletal realignment when they are combined with elastics or other types of appliances. One limitation of braces is they are quite visible and the metal brackets can cause discomfort.



Another common treatment for correcting mild to moderate teeth midline shift in adults is invisalign. When a deviated midline occurs with a crossbite or other bite issues, Invisalign can be combined with other dental appliances to correct the issues. A major benefit of invisalign is that it is far less noticeable and can be removed for a few hours each day.


Hyrax expander

Another solution for repairing teeth midline shift is a Hyrax expander. This expander is attached to the teeth and positioned in the roof of the mouth to expand the upper jaw. The expander can create additional space and allow the teeth to shift into the desired position. A Hyrax expander can typically be worn for up to nine months.



The dentist may also opt to extract a tooth as a treatment for correcting the teeth midline shift. The additional space in the mouth following an extraction can allow for the teeth to move into place and eliminate gaps in the mouth. Tooth extraction may be used in combination with additional treatments listed above in order to accomplish the desired results.


In severe cases, surgery may be needed to correct the dental midline shift. This is common when there is a structural issue. The dentist typically suggest surgery and extraction as a last resort.


Patients with a midline shift or misaligned midline should follow up with their dentist to discuss the condition and their options for treatment.

What Causes Misaligned Midline Teeth