An uneven jaw, also known as facial asymmetry, is a common condition that can affect both the appearance and function of the mouth and face. This misalignment occurs when the upper (maxilla) and lower (mandible) jaws do not properly align. While minor asymmetry is common, noticeable differences can be a concern. An uneven jaw can often be improved or corrected through various dental and medical interventions.
Understanding Jaw Unevenness
An uneven jaw involves more than a cosmetic difference; it can impact functions like chewing, speaking, and breathing. This condition often stems from a misalignment of the teeth, a temporomandibular joint (TMJ) disorder, or trauma. Malocclusion, where upper and lower teeth do not fit correctly, is a common factor.
Factors contributing to an uneven jaw include genetic predispositions, developmental issues like abnormal growth patterns, and injuries or trauma to the face or jaw, such as fractures or dislocations. Habits like prolonged thumb sucking, pacifier use, chewing predominantly on one side, or teeth grinding (bruxism) can also influence jaw development. Rarely, tumors or abnormal growths in the jaw area can also cause asymmetry.
How Jaw Unevenness is Assessed
A comprehensive assessment determines the underlying cause and extent of jaw unevenness, guiding treatment. This diagnostic process involves orthodontists and oral and maxillofacial surgeons, who evaluate the jaw’s structure and function.
The assessment begins with a physical examination, observing facial symmetry, jaw movement, and bite. Dental impressions, which create a detailed model of the teeth and bite, often follow. Diagnostic imaging, including panoramic and cephalometric X-rays, provides detailed views of the teeth and jawbones. More advanced techniques like CT scans and 3D imaging offer a three-dimensional understanding of skeletal structures and soft tissues, allowing precise measurement. This evaluation helps pinpoint the unevenness’s origin: dental, skeletal, or joint-related.
Non-Surgical Treatment Options
Non-surgical approaches are effective for jaw unevenness that is not severe or primarily involves dental misalignment. Orthodontics, using appliances like braces or clear aligners, is a common method to correct bite issues (malocclusion) by gradually shifting teeth into proper alignment. This improves balance between the upper and lower jaws, especially when unevenness stems from tooth positioning rather than skeletal discrepancies.
When temporomandibular joint (TMJ) disorders contribute to jaw unevenness, splint therapy or physical therapy may be recommended. Custom-made splints, resembling mouthguards, stabilize the bite, reduce TMJ pressure, and alleviate pain. They help reposition the jaw and relax muscles for a more balanced bite. TMJ physical therapy involves exercises to improve jaw movement, strengthen muscles, and reduce tension, including jaw stretches, resisted movements, and posture correction. For minor dental asymmetries affecting appearance, cosmetic dentistry solutions like veneers or dental bonding can reshape teeth for a more uniform smile.
Surgical Treatment Options
When non-surgical methods are insufficient, especially for severe skeletal discrepancies or functional impairments, surgical interventions are considered. Orthognathic surgery, or corrective jaw surgery, repositions jawbones for proper alignment and improved facial balance. Oral and maxillofacial surgeons often perform this surgery with orthodontic treatment.
Maxillary osteotomy repositions the upper jaw to correct issues like open bite, crossbite, or a receding upper jaw. Mandibular osteotomy moves the lower jaw forward or backward to correct overbites or underbites. In complex cases, both upper and lower jaws may require repositioning in a bimaxillary osteotomy (double jaw surgery). Genioplasty, or chin surgery, may also be performed concurrently to reshape the chin, enhancing facial harmony. These procedures involve precise cuts in the jawbone, moving segments into position, and securing them with small plates and screws, often placed internally to avoid visible scars.
Life After Treatment
Following treatment for an uneven jaw, patients enter a recovery and maintenance phase. For surgical interventions, initial recovery involves managing swelling, discomfort, and a modified liquid or soft food diet for several weeks to allow jawbones to heal. Swelling often peaks within 48 to 72 hours and subsides over two to six weeks; complete healing can take several months to a year. Post-operative care includes oral hygiene, pain management with prescribed medications, and keeping the head elevated to reduce swelling.
Long-term care and retention are essential to maintain results from both surgical and non-surgical treatments. After orthodontic treatment, retainers prevent teeth from shifting back (relapse). These retainers, removable or fixed, stabilize teeth as surrounding bone and tissues adapt.
Regular follow-up appointments with the orthodontist or surgeon monitor healing and ensure correction stability. For TMJ treatments, continued physical therapy and lifestyle adjustments (e.g., avoiding teeth clenching) sustain improvements. The goal is lasting functional and aesthetic improvements, contributing to better oral health and comfort.