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HomeAnswersOrthodontistmidline shiftCan midline shift be treated with elastics?

My midline is shifted to one side after braces treatment. How to correct it?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Bharat Joshi

Medically reviewed by

Dr. Vinodhini J.

Published At February 3, 2021
Reviewed AtJuly 13, 2023

Patient's Query

Hello doctor,

I have this issue where my midline is shifted. It is not centered as it should be, and like the whole arch (mandibular and maxillary) is shifted as if you just pulled it from one side. It shows in the picture, especially with the back camera, which made me insecure about myself. I am wearing braces, and I have been wearing them for a year and a half now. My orthodontist removed the lower braces and is willing to remove the upper one in the next appointment. Although I told him about my problems, he says that it is not that much, but your age pictures show the opposite. What are the treatment in my case like? Can it be treated with elastics or what? I have pictures of my teeth.

Answered by Dr. Bharat Joshi


Welcome to icliniq.com.

I can lessen your discomfort. Yes, as per seeing your picture (attachment removed to protect patient identity), you have mid-line asymmetry, but this asymmetry will decrease as age advances. You can ask for a quad-helix or RME (rapid maxillary expansion) appliance to improve the mid-line shifting. Right now, you can wait for one to two years.

The Probable causes

The probable cause is growing body and excess force on one side.

Differential diagnosis

The differential diagnosis is mid-line shifting (picture confirmation).

Probable diagnosis

The probable diagnosis is mid-line shifting (picture confirmation).

Treatment plan

Wait for one to two years.

Preventive measures

Use Quad helix or RME (rapid maxillary expansion).

Regarding follow up

I think you may wait for one to two years. After that discuss the two techniques. As per my knowledge, elastics alone are not useful.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Bharat Joshi
Dr. Bharat Joshi


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