Midline misalignment (also called midline discrepancy or deviated midline) is an incredibly common condition among adults characterized by asymmetry in the center points of one or both dental arches. You might know it better as the condition that Tom Cruise famously sported braces to correct in 2002.
Fortunately, most of the concerns surrounding midline misalignment are cosmetic and it presents very few side effects. Although more severe cases can cause difficulty chewing and a crossbite in the back teeth. Even so, it’s often a fairly harmless and treatable condition.
In fact, there are a few safe, affordable, and effective options for correcting midline misalignment that can deliver stunning smile transformations. Thinking about a treatment for your smile? By researching each option, you can find one that’s an ideal match for your goals and budget. The best part is that we’ve already done the research and compiled it all right here. Read on to learn more about midline misalignment and some of the best treatment routes.
Table of Contents
What is Midline Misalignment?
If you look in the mirror and draw an imaginary line down the center of your face, it should pass between your eyes, over your nose, and between your two front teeth. But for the large number of adults who have midline misalignment, this isn’t the case. This condition makes the middle of one or both arches slightly off-center. They might not line up with each other or the rest of your facial features.
The truth is that many people have midlines that are very slightly misaligned, but it’s often a small, barely-noticeable deviance. In many cases, it doesn’t even require treatment.
What Causes Midline Misalignment?
A few of the most common midline misalignment causes include missing teeth, oversized teeth (macrodontia), undersized teeth (microdontia), the early loss of baby teeth, crowding, and jaw misalignments.
Midline discrepancies can also stem from certain habits. For example, excessive childhood thumb-sucking can cause teeth shifts that alter the midline. Uneven chewing can also, over time, induce similar shifts. Or, they can occur after dental trauma like tooth loss or jaw injury.
Is It a Medical Issue?
The good news is that, in most cases, midline misalignment doesn’t present a serious medical concern. Most adults seeking treatment for this condition do so for purely cosmetic purposes.
But anytime your teeth are misaligned, it can potentially affect your bite. More severe midline discrepancies can alter your backbite, causing uneven wear on your teeth. Certain midline misalignments can occur simultaneously with a posterior crossbite (in your premolars and molars) that may lead to increased tooth decay, gum disease, jaw pain and more. In these situations, treatment may be more complex and robust.
The silver lining, though, is that a few different treatments have proven effective in correcting midline misalignment. So, whether you have a minor cosmetic deviation or a more complicated bite issue, it’s highly treatable. If your misalignment causes any physical or emotional stress, don’t worry – there’s a solution that can deliver the smile transformations you want.
Top 4 Ways to Correct Midline Misalignment in Adults
Even though midline misalignment is a common condition, your specific case, goals, and budget are all unique. Fortunately, there are a few different treatments available, so you can choose the one that best fits your priorities and lifestyle. Read over these options and you’re bound to find one that works for you. But don’t forget to consult your dentist to get a professional analysis and recommendation as well.
Without further ado, here are the four best treatment options for midline misalignment:
Braces are incredibly effective at correcting midline misalignments, even when it’s caused or accompanied by a more complex issue such as crossbite. In addition to dental correction, braces can also achieve a degree of skeletal realignment when paired with elastics and other specialized appliances. The main downside of braces is their visibility, since most adults favor treatment options that are less conspicuous.
If your deviated midline is caused by an underlying bite issue, braces are an excellent treatment option, often working more quickly than other correction methods. That said, treatment with braces can be pretty pricey, generally ranging between $3,000-$7,000. If your midline misalignment is not accompanied by any other complications, it may be worth considering one of the other less invasive (and less expensive) treatment options on this list.
Thinking about getting braces? Check out our guide to treating midline misalignment with braces, which covers different types of braces, costs and other important considerations in greater detail.
Known for having pioneered the world’s first clear, removable teeth aligners, Invisalign is another viable treatment option for correcting moderate midline misalignments in adults. If your deviated midline is accompanied by crossbite or some other bite issue, Invisalign can be paired with additional dental appliances to help correct it, just like traditional braces. However, unlike braces, Invisalign can be provided by a standard dentist (rather than an orthodontist), so there’s a good chance your treatment can be administered at the same place you go to get your teeth cleaned.
Of course, the most notable differences between these treatment methods are that Invisalign is 1) removable, and 2) much more discreet than traditional braces. That said, Invisalign clear aligner trays are able to shift your teeth about equally as quickly as braces, and for approximately the same price (between $3,500-$8,000).
Considering Invisalign? Read our guide to treating midline misalignment with Invisalign, which covers options, costs and other important considerations in greater detail.
3) At-Home Teeth Aligners
While Invisalign remains the best-known option for removable teeth aligners, there are many others available today. In the past few years, a number of online companies like Smile Direct Club have entered the industry to provide a more affordable option for adults seeking to straighten their teeth and correct midline issues from home.
However, home aligners are only a good option for certain cases of midline misalignment, primarily ones that are fairly mild and not accompanied by other bite issues like crossbite. If your backbite is normal and your midline discrepancy is slight, home aligners can be a great option. But if you have a posterior crossbite, they might not be able to make the necessary shifts. Before beginning treatment, you’ll need to submit impressions or scans of your dental arches so that the company can determine whether their treatment can deliver the results you’re after.
If so, you’ll receive a set of clear, removable aligners customized to your teeth by a dental professional — but unlike Invisalign, your care will be handled entirely remotely and not require any trips to the dentist’s office.
Home alignment products are significantly more affordable than braces or Invisalign, with an average cost of $1,800-$2,000. All in all, unless your midline discrepancy is compounded by a severe bite misalignment, home teeth alignment could be a viable option for you.
To learn more, we encourage you to read our review of the top 5 home teeth aligners.
Interested in learning more about at-home teeth aligners? Visit our guide to treating midline misalignment with at-home aligners, which covers options, costs and other important considerations in greater detail.
A popular alternative to dental realignment, veneers are thin but sturdy pieces of porcelain that bond to your teeth in order to transform your smile instantaneously.
Truth be told, veneers have about as many major upsides as they do downsides for correcting minor cases of midline misalignment. On the positive side, veneers offer the possibility of immediate gratification and cause much less discomfort than physically shifting your teeth. The downside is that your dentist will need to shave down your real teeth to effectively place the veneers. Plus, they aren’t a permanent solution, as they do not actually correct the underlying issue.
Depending on the type you choose, veneers last anywhere from 7-20 years (after which they need to be replaced), and cost between $500-$2,000 per tooth. If you’re seeking a way to enhance the appearance of your smile as quickly as possible, veneers may be worth considering.
Intrigued by veneers? Check out out our guide to veneers, which covers the pros and cons of this treatment option in much greater depth.
When you look in the mirror, you might be fixated on your midline misalignment, worried about how it looks. If so, keep two things in mind. First, you’re not alone, as it’s a common and widespread condition. Second, it’s often not medically serious and you have a variety of safe, effective, and affordable treatment options. Whether your motivation is simply cosmetic or stems from a medical concern, there’s a route that can deliver the smile transformations you want.
Before committing to any particular treatment, you should schedule an examination and consultation with your dentist, then evaluate your own priorities. This way, you can continue researching the options listed here within the context of your own unique circumstances. You might even decide against treatment altogether, and that’s totally fine – your smile is beautiful either way.