An uneven jaw occurs when there is a mismatch or misalignment between your upper jaw bone (or maxilla) and your lower jaw bone (mandible). This can be caused by anything from temporomandibular joint (TMJ) disorders and trauma to dental issues like an uneven bite.

Crooked jaw severity varies, with more severe cases exhibiting symptoms such as an asymmetrical face, pain in the temples, ear-popping, and chewing difficulties. Treatment options include orthodontics, surgery, and symptom management. 

Reasons for a Crooked Jaw

A crooked jaw can be caused by congenital disabilities, issues as the teeth and jaw develop (developmental), or trauma or accidents (acquired). Here's a quick summary.

TMJ Disorders

The temporomandibular joint (TMJ) connects the maxilla to the mandible. TMJ disorders (also known as "TMJs" or "TMDs") are a common cause of crooked teeth. They occur when there is a problem with the joint or with the surrounding muscles or ligaments. TMJ issues, which cause inflammation, pain, and other symptoms, can be caused by arthritis of the jaw, teeth grinding or clenching (bruxism), a misaligned bite, injury, stress, and joint dislocation.

Trauma

Falls or accidents can also cause a crooked jaw. For example, after a fracture of the mandible or maxilla, healing can be uneven, jeopardizing their alignment. This type of uneven jaw can occur at any age, but people with osteoporosis or low bone density are more likely to sustain long-term damage. This is why doctors will closely monitor and care for you as you recover from a broken bone or traumatic injury.

Birth Defect

Many cases of an uneven jaw can be attributed to congenital disabilities that affect facial symmetry. This congenital condition, known as "hemifacial microsomia," primarily affects the jawbones. It causes irregularities on one side of the face (unilateral) or both sides (bilateral) (bilateral). This can cause canted teeth (slanted teeth when compared to the nose and mouth), a chin pointed off to one side, and other asymmetries in the lower side of the face, depending on severity.

Severe cases, especially if bilateral and untreated, can result in obstructive sleep apnea (snoring and disruption of sleep) and Pierre-Robin syndrome (a severe under formation of the mandible at birth). A crooked jaw is also linked to cleft palate and lip, both of which are congenital disabilities.

Symptoms of Uneven Jaw 

An uneven jaw, depending on its severity, can significantly impact the health of your gums, TMJ muscles and ligaments, bones, and teeth. The primary symptoms of a crooked jaw are pain in the temples, headaches or pain in the shoulders and back, clicking, grinding, or pain in the jaw, ringing, buzzing or popping in the ears, and tightness and pain in the jaw.

Treatment of Uneven Jaw 

Surgery

Surgery to correct an uneven jaw is known as "orthognathic surgery," and it is usually reserved for more severe and advanced cases. These procedures aim to reshape the upper or lower jaw to align everything properly.

Following surgery, or in the case of a jaw fracture, temporary jaw wiring or the use of pins may be required to support the structure and help correct the misalignment.

Dental Appliances

Orthodontics and the use of dental appliances can help correct an uneven jaw caused by a malocclusion. In addition, the pressure applied to the teeth and jaw over time—typically 18 months to two years—promotes a healthier alignment.

Pain Management

Managing the pain and inflammation associated with a crooked jaw, especially if there is a TMJ disorder, is an important aspect of treating the condition. A variety of approaches, ranging from lifestyle changes to alternative therapies, can be beneficial.

The Bottom Line 

While having a crooked jaw can be a real pain, it's important to remember that there is a lot you can do to fix it. Orthodontics has demonstrated a high level of efficacy in addressing the issue, and surgeries have successfully helped countless patients.

What's most important is that you get the help you need if you're experiencing jaw pain, functional issues, or other symptoms. Calling your doctor can be the first step toward a healthier, more comfortable smile.