According to New York cosmetic dentist Jason Kasarsky, DDS, a narrow palate can be immediately determined by looking in the mirror and counting the amount of teeth showing when smiling. “Seeing six or fewer front teeth indicates a narrow smile,” he says. This type of mouth shape—the mouth’s arch comes to a point at the front instead of a gradually sloping curve—can stem from many different causes like misaligned teeth or skeletal issues, but Dr. Kasarsky says there’s a way out. “With help from a cosmetic dentist, you can create a definitive treatment plan for the most aesthetically-pleasing result.”
What is a narrow smile?
Aside from seeing fewer than six teeth when smiling, New York cosmetic dentist Irene Grafman, DDS reports that you can determine a narrow smile by taking a look at your upper palate. According to her, the upper jaw and palate will have a more tapered shape than the average mouth, and it will also be higher.
Atlanta cosmetic dentist Ronald Goldstein, DDS adds two other ways you can determine whether or not you have a narrow smile. “First, If your dentist takes an impression of your upper jaw and pours a model, you can easily see your upper palate. Second, you can also take a photograph of your upper arch either with a good mirror and phone camera yourself or have a friend take the photo for you.”
According to Dr. Karasky, a narrow smile can occur from many different causes. “The cause of a narrow smile can come from a small-width top arch, which is a skeletal issue,” he says. “Many times, the top arch (also known as a maxilla) is V-shaped with a high vaulted palate as opposed to a U shape with a non-vaulted palate. It can also be caused by the misalignment of teeth and missing teeth.” Dr. Goldstein adds that your genetics may also be the cause, especially if one of your close relatives has the condition.
What are the side effects of a narrow smile?
Chevy Chase, MD cosmetic dentist Claudia Cotca, DDS says that the biggest issue with a narrow arch is that it can be restrictive to the tongue. “Tongue restriction can lead to unfavorable breathing patterns, teeth movement, clenching and grinding. There are complex variables involved, but there is a golden proportion to the mouth, which applies to every individual’s oral systemic profile.” Dr. Kasarsky adds that a narrow smile also affects overall facial aesthetics: “A narrowing smile means that your cheeks aren’t being supported as much as they can be, which can cause an aging appearance.”
When are narrow smiles typically corrected?
The saying “earlier is better than later” reigns true when it comes to diagnosing a narrow smile. According to Dr. Cotca, the appropriate evaluation of a narrowing smile during early years of development can make a major difference. “Early intervention not only results in avoiding or limiting unfavorable results in adult life, but it can promote a healthy lifestyle and aesthetic superlatives earlier in life with minimal requirement of treatment later down the line.” But, it’s important to know what kind of doctor to visit. “Either the child’s pedodontist or, later, an orthodontist can advise treatment,” says Dr. Goldstein. “In extremely narrow arches, orthognathic [jaw] surgery may be necessary.”
Assess sleep patterns
“When patients have a narrow smile, we start with an assessment of their sleep and airway to ensure they don’t have any sleep-related breathing disorders like obstructive sleep apnea,” says Washington D.C. cosmetic dentist Elana Shlansky, DDS. From here, she says it’s all about putting together a comprehensive treatment plan that addresses all of the patient’s concerns.
Take a multifactorial approach
“Correcting a narrow smile comes down to three different elements: craniofacial skeletal, muscle and neurological,” says Dr. Cotca. “Appropriate improvements distinguish themselves by the multifactorial impact the intervention carries across the entire face, including but not limited to postural position and breathing, which is key for continued smile improvement and stable maintenance with age.” In her practice, she looks at all three of these elements so that minimal tooth structure, enamel or dentin is removed and that it is instead retained and straightened.
Start with straightening
Dr. Kasarsky also opts for a multimodality treatment, but he likes to start with Invisalign. “Orthodontics, as in clear aligner therapy like Invisalign, is an option that works well for those whose teeth are in excellent condition,” he says. “Expanding arches and moving teeth to appropriate positions can do the trick. There are cases that I manage where we move teeth and then veneer them to get what we call a ‘cheek lift.'” However, the veneers he often applies in his practice, which are known as prep-less veneers, do not require removing tooth enamel. “Instead, these are placed on an unprepared tooth,” he says. Another option he offers for a quick fix: “Have plastic veneers made to go over the fronts of teeth. They’re basically a snap-on smile for the event of the evening.”
Or, opt for an expander
“A full discussion and evaluation from specialists including orthodontists and oral surgeons is deemed necessary,” says Dr. Cotca, who adds that an orthodontist can provide an expander to your smile re-design process, among other treatments. “This is one of the various suitable treatments that expands a narrow, restrictive palate and establishes the proper wider perimeter.”
While expanders can be used at any age, Dr. Cotca’s recommendation to get your narrow smile evaluated when you’re young remains important. According to Healthline, treatment gets harder as you age, which is why expanders are recommended for young adults and children. A small 2017 study showed that expanders are most commonly used in children and teenagers under 15 years old before the palate finishes growing.