If you have canted teeth, it means that your smile is slightly tilted, or there’s an asymmetry to your teeth in relation to the gums and lips. It might be that your pearly whites are otherwise healthy and strong, but you notice that something looks off when you smile in photos. This can affect your self-confidence.
If you suspect that you have an asymmetrical smile affecting your upper teeth or lower teeth, cosmetic dentistry can help. The first step is understanding what causes canted teeth and which treatment option is right for you.
What Is a Canted Smile?
The "cant" or line of your teeth usually appears straight when the frontal occlusal plane (the front view of your smile) is parallel to your ears, eyes, and nose. If you took a photo of your face and overlaid it with an axis, the cant line would be at a 90-degree angle to your facial midline (sometimes called the dental midline).
While many straight-looking smiles may actually be slightly tilted, a canted midline starts to be noticeable at an angle of 4 degrees or more. Both lay observers as well as dental professionals—including general dentists and orthodontists—start to notice a tilt at 4 degrees.
Are Canted Teeth a Problem?
Canted teeth are usually only a cosmetic concern, especially if the tilt is minimal. However, for some people, an imbalanced smile may involve functional issues such as skeletal developmental problems and tooth wear, or the cant may cause difficulties with the eruption of teeth.
A Simple Trick for Checking Your Cant
If you suspect you may have canted teeth, here's a simple trick to try. Take a tongue depressor or popsicle stick and bite down on it. If the line is tilted or your teeth look tilted in relation to the stick, you may have a canted smile. However, the best way to confirm occlusal plane canting is to make an appointment at your local dental practice.
Causes of Canted Teeth
There are several possible causes of a canted plane, which may require different kinds of treatment in order to correct. Some of the most common causes are:
Jaw alignment issues. A mandibular deviation (in your jaw), such as an overbite or crossbite, can lead to an uneven smile. Skeletal asymmetry can also result from horizontal bone loss if the bone loss occurs unevenly.
Tooth alignment issues. Misaligned teeth, crooked teeth, and crowded teeth can all create an uneven appearance. Adjacent teeth of different lengths can also lead to a canted smile.
Uneven gums. When your teeth erupted as a child, the gums receded to reveal your smile. If the gum receded unevenly or you experienced gum recession later on, this might have affected the aesthetics of your smile.
Trauma. Tooth-grinding or a blow to the mouth can both lead to occlusal canting if the teeth on either side of your mouth are affected by the trauma to different degrees.
Oftentimes, canted teeth are caused by a combination of factors and will need several procedures to correct. Your dentist will analyze the causes of the tilt when deciding which treatment options would be most appropriate for you.
Treatments for Canted Teeth
The best treatment plan for occlusal plane canting will depend on the cause(s), the level of functional risk, and your aesthetic goals for an “ideal smile.” In your initial smile analysis, your dentist will analyze structural, biological, functional, and aesthetic factors that should be addressed in the final plan.
If jaw misalignment is an issue, your dentist may recommend surgery or orthodontic treatment to correct your mandibular position, including:
Skeletal anchorage with intrusion and extrusion
Aligners, such as Invisalign
Surgery, braces, and extrusion wire should be reserved for the more severe cases where the misalignment is causing a health problem (such as digestive issues or sleep apnea). In most cases, Invisalign is an excellent option for correcting alignment with a minimum of discomfort.
Biological and Restorative Dentistry Treatments
Problems with the teeth and gums may be contributing to the cant or simply affecting your oral health. Either way, your dentist may recommend any of the following dental procedures as part of your treatment plan:
Gum contouring to alter the gingival margins if you have a gummy smile
Periodontal surgery such as gum grafts to fill in gaps from receding gums
Dental fillings, inlays, and onlays to repair cavities
Root canals, porcelain crowns, and bridges to protect heavily worn teeth
Throughout the process, your dentist will help you work toward a straight smile while correcting biological problems. Photographs of treatment progress can show you just how each step is contributing to the goal.
In some cases, the problems that led to canted teeth may put you at risk for greater tooth wear or cause difficulties when chewing your food. Procedures such as crown lengthening or crown replacement can correct the angle of occlusal contacts while also improving the angle of your smile.
If you are missing a tooth, a dental implant can be placed to help maintain or restore a straight smile. Dental implants are made from porcelain and are as strong as a natural tooth, so they can restore the functionality of your bite if the missing teeth make chewing difficult.
Finally, issues such as short or slightly crooked teeth can be masked with aesthetic treatments, such as cosmetic bonding, porcelain veneers, and crowns. These additions would be placed as the final stage of your treatment plan—after the structural, biological, and restorative procedures are complete.
Cosmetic bonding is a simple and quick process in which a composite resin is applied to a tooth. It is typically used to fill in a chip or lengthen an especially short tooth and can quickly create a more even look. Just as in a filling, the surface is roughened and the resin glued on with a dental adhesive.
Veneers were invented by Dr. Charles Pincus in the late 1920s to cover the crooked teeth of Hollywood actors during filming and photoshoots. At that time, they were temporary clip-ons made from acrylic material. Today's veneers are most commonly made of porcelain and are permanently cemented to the teeth. The treatment time is quick; most veneer procedures require no more than three appointments.
For those seeking a different treatment alternative, a crown or bridge can serve both a practical and aesthetic function when the length of your teeth results in a slant. A crown can be made to look like a natural tooth while ensuring a straight line across your mouth. It also provides long-term stability to underlying teeth.
A Smile Makeover Takes You Beyond Canted Teeth
A more extensive smile makeover can address the issue of asymmetry while improving your smile aesthetics overall. In a smile design consultation with a cosmetic dentist, you will discuss your goals and the dentist will perform a thorough assessment of your teeth.
While Invisalign and periodontal surgery may be enough to correct a canted smile, you might wish to add veneers and laser tooth whitening to perfect that red-carpet look. A complete smile makeover is often chosen by patients to boost their confidence and open up new professional opportunities. If your goal is to get perfect teeth like celebrities, a smile makeover is a way to go.
Canted Teeth: Key Takeaways
We’ve covered a lot of information here, but the basics are pretty simple:
"Canted teeth" refers to a smile that looks tilted compared to the line of your ears, eyes, and nose.
A canted smile is particularly noticeable if the angle is 4 degrees or more.
Common causes of a canted smile are misalignment issues with the jaw or teeth, an uneven gum line, or trauma to the mouth that affected the sides of the mouth unequally.
If you would like to correct this aesthetic (and/or functional) issue, cosmetic dentists offer various treatments that can help to solve the root cause of the cant. Typically, this might involve a combination of gum surgery, Invisalign, crowns, and veneers. If you're ready to achieve the smile of your dreams, reach out to an experienced cosmetic dentist to find out whether these treatments are right for you.