Deviation of the philtrum and some effective treatment methods

Midline deviation, also known as deviation of the philtrum, is a very common condition in adults characterized by midpoint asymmetry in one or both upper and lower jaws. In the article below we will share more details about this situation.

How to recognize deviation of the philtrum?

First, how to recognize a deviated philtrum? Look in the mirror or see a photo of your face with the upper and lower front teeth, then draw a straight line dividing the face to the point between the eyes, the top of the nose, and between the upper and lower front teeth. If the line is not straight but appears curved in the middle of the teeth, it means the philtrum is misaligned. The situation will encounter the upper or lower jaw, or both jaws.

In fact, most adults do not have a mid-face line, but the number of people with this deviated philtrum is relatively large, it is very difficult to detect and does not affect aesthetics, so there is no need for surgery to treat it. According to authors Miller and colleagues, only about 70% of people have a midline of the upper jaw similar to the midline of the nose, and 25% of people have a midline of the upper jaw with the lower jaw similar to this line.

Deviation of the maxillary midline will have less aesthetic impact than deviation of the mandibular midline if it does not follow the same facial angle. Therefore, if the mandibular philtrum deviation is not accompanied by facial deviation, it will not require surgery and will be treated completely free of charge.

Patients can easily see their own condition if it is a problem they have and express it on the outside, which is sometimes considered normal. However, it is many times more difficult for a dentist to diagnose jaw misalignment. The dentist will have to have all the data when examining from the inside of the mouth – on the outside such as taking photos and videos of the teeth and the outside face, marking the jawbone at the center edge, charting the occlusion, and watching facial films. Tilt cephalo, panoramic film, plane film.

There are at least 6 midlines in the craniofacial complex that need to be examined: the midline of the mouth, the midline of the skull, the line between the maxilla and mandible, and the line between the upper and lower teeth. From there, the dentist can conclude whether the deviation is in the teeth or bone, what is the origin, can it be corrected, or does it require surgical intervention.

See more: 5 effective ways to fix deviated faces. What should I do if my face is skewed left or right?

Causes of philtrum deviation

There are a number of causes that cause the philtrum to deviate and cause tooth loss that cannot regrow, such as large tooth disease (macrodontia), causing baby teeth (microdontia) due to replacement of colostrum teeth, protruding teeth, and jaw bone deformity.

Deviation of the philtrum can also be caused by bad habits such as thumb sucking causing the teeth to tilt, the habit of biting one side of the jaw for a long time or simply forming after an unwanted injury. . Another cause of a deviated philtrum is orthodontic complications. This is also an issue that many people who are having orthodontic surgery worry about.

Is philtrum deviation dangerous?

Is philtrum deviation dangerous? The good news is that most of these cases of philtrum deviation do not result in any health problems. Treatment requirements are often cosmetic related.

However, some types of philtrum deviation have the risk of affecting the chewing function, such as secondary teeth crossbite after surgery or gingivitis, tooth decay or temporomandibular joint disease. And the treatment has also become more complicated, with more advanced techniques.

You don’t need to worry, because today modern dentistry has almost finished handling all cases of moderate to large philtrum deviation.

How to treat philtrum deviation?

How to treat philtrum deviation? Dental braces are simple and effective tools capable of correcting minor to severe chewing misalignments. The dentist will use brackets to install directly on the teeth and adjust and arrange the teeth according to his wishes.

Because braces help move teeth to the meeting point, they completely preserve the original teeth, effective in cases of long horizontal misalignment, vertical misalignment or misaligned chewing. ..

The cost of treatment with braces is about 25-35 million/2 jaws. And the time is about 1.5 to 2 years depending on the type of tooth misalignment.

Braces, if not managed by a dentist, can also cause midline deviation. On some dental forums, many people ask questions.

Why is it that the more you get braces, the more your philtrum becomes misaligned? What should you do if you’re almost removed and your philtrum is misaligned? After getting braces, my face is crooked, what should I do?

In fact, braces have the power to cure philtrum deviation, but if the dentist’s treatment plan is not meticulous, this detail can be overlooked, leading to loss of control over the position of the front teeth, which will eventually lead to ugly.

To correct the midline in case you have orthodontic complications, the dentist can use intermaxillary elastics, split the midline, even extract teeth or apply advanced MEAW techniques. Specifically, some techniques to correct midline deviation include:

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Use a personalized brace attachment chart

On some braces forums, when you post a picture of yourself and ask many people if the doctor put the braces on you correctly like this? Some people said the doctor was wrong. Actually, attaching braces does not follow just one rule. In many cases, because of implementing the plan, doctors have to do it manually, only applying it to each specific disease.

The case of philtrum deviation related to tooth deviation on the bone base axis is also an example. When you go to the dentist, the dentist will attach a reclining tube to the bracket so that when the wire is inserted straight, it will increase the force to help the teeth fit tightly together.

Use bows with Cantilevers

This method is quite perfect for creating incisal axis, it is also very useful in cases where tip adjustment is needed when the entire incisor group is misaligned in the fixed bone base area. Because this arch wire is less susceptible to damage and the force is mechanical in the area of effect. The force generated from this method is average, uniform at points of the incisal arch that are far apart and changes over time.

Using asymmetric mechanics

Using disproportionate mechanical force is similar to the indication for cutting on one side for tooth extraction surgery. Chain elastic is also used to reduce asymmetry. The same method applies to moderate philtrum deviation. If it is too large, it will be difficult to manage.

Indications for asymmetric tooth extraction

In essence, this is a way to use the jaw to collect teeth. When the spaces form, asymmetry will balance the current asymmetric tooth condition. It will often be necessary to combine intermaxillary mechanics with sequences to achieve optimal treatment results.

Adjustment of occlusal plane rotation, advanced meaw technique

Can be used in cases of philtrum deviation or jaw bone asymmetry. This is a difficult but highly effective method. In addition to the above uses, after having a deep understanding of orthodontic mechanics, the orthodontist will flexibly and creatively apply force systems to be able to control the midline to suit you.

First, we will take some examples of using braces to correct philtrum deviation

You can see more clearly from the image taken inside the mouth, we have drawn 2 straight lines going through the upper and lower midline for your convenience.

A deviated philtrum causes the face to be completely misaligned, making the defect even more obvious when smiling.With philtrum deviations like the above, in the past, jaw surgery was needed to correct it, but now at BEDENTAL we use the MEAW technique, which is a wire-breaking orthodontic technique. Normally, you see the wire coming in. The teeth are semi-elliptical in shape, while with the MEAW technique we shape them in a stepped shape to actively control each side of the tooth through rotation of the chewing plane. Once installed, you can observe the treatment progress according to the stages and the midline is precisely calibrated.

And the face has completely stopped skewing. Very effective, isn’t it?

The second method is to use Invisalign orthodontic trays

Invisalign is the only internal braces company in the world, and currently Invisalign also has full scientific evidence of safety and long-term stability. The mechanism of invisalign is to use a series of transparent aligners that cover the entire tooth crown, each aligner moves about 0.25 mm and you will replace the aligners every 2 weeks. Maybe you don’t know that braces are very good at correcting midline deviation.

The disadvantage of transparent braces is their high cost, but because of their convenience and comfort, they are currently quite popular.

We will take an example of using Invisalign braces at BEDENTAL 

My client and colleague has a deviated philtrum in both the upper and lower jaw. We plan to use Invisalign without brushing, aligning both jaws and adjusting the midline of the mouth. After surgery, you will see that the line between the upper and lower jaw is quite even. From then on, my face also became more aesthetic. Invisalign braces are especially useful for cases of horizontal misalignment.

Deviation of the philtrum causes the face to look straight ahead, causing a slightly crooked feeling when smiling. After 1 and a half years of full set Invisalign treatment. We completely fix all of the above problems.

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The third solution you can choose is porcelain veneers or full porcelain crowns

The principle is that the dentist will grind and shape your teeth, then trim the lower side of the jaw and begin attaching new orthodontic teeth. However, this treatment is not acceptable when the philtrum deviation is too large, so you need to make new teeth for optimal orthodontics.

Because the treatment requires jaw reduction and is a complicated procedure, you need to be cautious when accepting the procedure. Because completely lost tooth tissue is difficult to regenerate, you should only get porcelain crowns when the midline is misaligned along with teeth that are dark, worn, broken, chipped, or have color and shape problems that cannot be handled well with braces. 

Hopefully this article has helped you gain an overview of the causes and solutions for the phenomenon of philtrum deviation, also known as mouth deviation. Braces are a perfect solution with moderate amplitude for long-term, sustainable results. In the next article, we will elaborate more on the issue of complications of philtrum deviation after orthodontics. We hope you will pay attention and read.

Below is the article that BeDental shared. If you have any questions that need answering or advice about your current condition, you can contact the team of doctors for the most detailed and dedicated answers.

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