Addressing Dental Bridge Issues: Asymmetry and Communication with Your Dentist

Q: Addressing Dental Bridge Issues: Asymmetry and Communication with Your Dentist

Hello： Dental occlusion is a very precise matter. <br>You may be suffering from "temporomandibular joint disorder" (TMJ disorder) which is causing your discomfort. <br>Firstly, after many years of missing teeth in your lower jaw, you may have lost your occlusal function without r

After getting dentures, my mouth is crooked on one side?

I feel very fortunate to have found this forum, where doctors provide detailed answers to many people in need of help.
I am currently facing a significant issue and hope you can clarify some doubts for me! I am 28 years old and have severe dental problems, with three missing teeth on the lower left and four missing teeth on the lower right (only the farthest right wisdom tooth remains).
After six years of procrastination, I finally decided to get dentures.
I had dental bridges placed on both the lower left and lower right, and I also had a bridge for one missing tooth on the upper right.
However, after the dental work was completed, I noticed that my face has become asymmetrical.
The right side of my face appears puffy (especially when I smile), and I feel like my mouth tilts to the left when I smile.
I suspect this is because the dentist made the upper right side too prominent compared to my natural tooth on the upper left.
Since all the bridges except for the lower right are now permanently bonded, the dentist keeps suggesting that I might have always looked this way.

I have several questions:
1.
Why does the right side of my face look puffier? Why does my smile appear crooked (the midline of my upper front teeth is shifted to the right)?
2.
Is it possible to adjust the position of the dental bridge to restore the midline to its proper position?
3.
I hear a sound and experience difficulty when opening my mouth on the left side of my jaw joint.
Should I seek further treatment at a major hospital?
4.
Can the bonded parts be removed for adjustments? How should I communicate my concerns and requests to my dentist?
I apologize for asking so many questions, and I would greatly appreciate any assistance you can provide.
Thank you very much!

adems77, 20~29 year old female. Ask Date: 2006/06/04

Dr. Huang Zhicheng reply Dentistry

Hello: Dental occlusion is a very precise matter.
You may be suffering from "temporomandibular joint disorder" (TMJ disorder) which is causing your discomfort.
Firstly, after many years of missing teeth in your lower jaw, you may have lost your occlusal function without realizing it, forcing yourself to chew with difficulty.
This can lead to overexertion of the masticatory muscles, muscle tension, and even dislocation of the articular disc in the left temporomandibular joint, resulting in a clicking sound when opening and closing your mouth without your awareness.
However, these occlusal issues develop gradually, and our muscles have an adaptive capacity, which may not cause significant distress.
But as you mentioned, after receiving multiple long dental bridges (5 to 6 units), this change is almost instantaneous, and the masticatory muscles may struggle to adapt, leading to muscle pain.
The dislocated articular disc on the left side has moved further forward, obstructing the movement of the condyle during mouth opening, causing the mouth to deviate to the left.
Regarding the right side of your face being more prominent, it may be related to the upper denture being too bulky towards the buccal side, which can be adjusted by remaking it thinner and trying it on.
As for the adjustment of the dental bridge, if there is a noticeable high centric occlusion (where the normal anterior teeth do not contact), protrusion, or lateral movement interference, it can be adjusted first.
It is best to wear an occlusal splint initially to alleviate some muscle pain and discomfort associated with TMJ disorder, and to eliminate the joint sounds before making detailed adjustments to the dental bridge.
Sincerely, Dr.
Huang Chih-Cheng, Dentistry.

Reply Date: 2006/06/04

More Info

Addressing dental bridge issues can be quite complex, especially when it involves asymmetry and discomfort. Your situation, as described, raises several important points that need to be addressed carefully.
1. Facial Asymmetry and Discomfort: The asymmetry you are experiencing, where one side of your face appears fuller and your smile seems to lean to one side, could be attributed to several factors. One possibility is that the dental bridge on the right side may indeed be positioned differently compared to your natural teeth on the left side. This can create an imbalance in how your facial muscles engage when you smile. Additionally, if the bridge is slightly higher or protrudes more than the adjacent teeth, it can lead to uneven muscle tension, causing the appearance of fullness on one side of your face.
2. Midline Discrepancy: The midline of your smile being off-center can also be a result of the dental work. Ideally, the midline of your upper teeth should align with the midline of your face. If the dental bridge is not positioned correctly, it can lead to this misalignment. In some cases, adjustments can be made to the bridge to help restore the midline, but this depends on how the bridge was fabricated and how securely it is bonded to the underlying teeth.

3. TMJ Symptoms: The clicking sound you hear when opening your mouth on the left side may indicate a problem with your temporomandibular joint (TMJ). This could be related to the new dental work, especially if your bite has changed. TMJ disorders can cause discomfort and may require further evaluation by a specialist, such as an oral surgeon or a dentist who specializes in TMJ disorders.
4. Adjustments and Repairs: If the dental bridges are securely bonded and you are experiencing significant issues, it may be challenging to simply remove and adjust them without compromising their integrity. However, if there is a legitimate concern about the fit or alignment, it is worth discussing with your dentist. They may be able to make minor adjustments or, in some cases, remold the bridge if it is deemed necessary.

Communication with Your Dentist: When discussing your concerns with your dentist, it is important to be clear and specific about the issues you are experiencing. Here are some tips for effective communication:
- Document Your Concerns: Write down your observations regarding the asymmetry, discomfort, and any other symptoms you are experiencing. This will help you articulate your concerns clearly during your appointment.

- Ask Questions: Don’t hesitate to ask your dentist to explain their reasoning behind the current dental work. Questions like, "What could be causing the asymmetry?" or "Can we adjust the bridge to improve my midline?" can open up a productive dialogue.

- Express Your Feelings: Let your dentist know how the changes are affecting you, both physically and emotionally. This can help them understand the urgency of your concerns.

- Seek a Second Opinion: If you feel that your concerns are not being addressed adequately, it may be beneficial to seek a second opinion from another dental professional. They may provide new insights or alternative solutions.

In summary, your situation involves multiple factors that could be contributing to the discomfort and asymmetry you are experiencing. It is crucial to have an open and honest dialogue with your dentist about these issues. If necessary, consider seeking a second opinion to explore all possible options for correction. Your dental health and comfort are paramount, and addressing these concerns proactively will help ensure a better outcome.

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