Protruded Mouth

Most people use mirrors to see their own reflection, which causes them to focus more on the front of their face. Others, on the other hand, can see the facial profile just as clearly as the front view. The profile plays a significant part in shaping your personal image since it provides people with a complete perspective of your face dimensions.

One of the main factors contributing to a bad face image is mouth protrusion. It alters the dimensions of your facial features, making your face appear larger; it causes nasolabial folds or chin wrinkles, making you look older; and it twists the contour of your mouth, giving you a pouty or angered appearance.

It not only causes aesthetic concerns but also health ones (e.g., difficulty in chewing because of malocclusion, dental cavities, allergies from mouth breathing, etc.). To rectify the protrusion itself, it is necessary to comprehend the reason for the mouth protrusion.

Protruding Mouth

A mouth protrusion is when, when viewed from the side, the mouth seems relatively protruded in comparison to the edge of the jaw or the nose.

The lower jaw (mandible), which includes lower teeth, and any portion of the upper jaw (maxilla), which includes upper teeth, are noticeably protruded forward when compared to the edge of the nose or jaw, respectively.

Based on the underlying etiology of mouth protrusion, the best surgical technique needs to be chosen. The growth of the upper and lower jaws, including the protruded area, the form of the protrusion, and the level of protrusion, require an accurate diagnosis. Only when there is a deep understanding and practical experience in orthodontics, mouth protrusion surgery, double jaw surgery, and facial contouring surgery are accurate diagnosis and appropriate treatment possible.

Protruded Mouth Causes

The primary causes of mouth protrusion are abnormally protruded teeth and gums. Three basic types of mouth protrusion exist:

The upper and lower jaw bones are normal, however, only the teeth protrude.
The gum is protruded and the teeth are straight.
The gum and teeth are both protruding out.

Protruded Teeth

Causes of protruded teeth (the most common cause of protruded mouth) include the following:

Genetics. Jaw shape is a genetic trait, which means that it is transmitted from parents to children. Therefore, the child may also have an overbite if the parents have one. Overbites are typically also observed in parents, siblings, or other close relatives if the reason is genetic.
Non-nutritive sucking behaviors. A behavior known as a non-nutritive sucking behavior (NNSB) involves a sucking action but does not deliver nutrition. This type of behavior is typically displayed as thumb-sucking or sucking on a pacifier and is particularly prevalent in very young children. When it persists past the ages of 3 or 4, thumb-sucking is one of the childhood behaviors that might cause or worsen overbites. This is because, at that age, permanent teeth begin to erupt, and the pressure from sucking and finger pressure cause the teeth to sprout laterally at an unnatural angle. When a child pacifies herself all the time, a similar issue can arise. Pacifier use puts toddlers at a higher risk of developing an overbite than thumb-sucking, according to the Journal of the American Dental Association.
Protruding tongue. Tongue-thrust occurs when the tongue protrudes too far forward in the mouth and presses on the backs of the front teeth. Poor swallowing habits, inflamed tonsils, or enlarged adenoids can all cause it. It may occasionally also be triggered by stress. In addition to raising the possibility of getting an overbite, tongue thrust is also linked to the open bite.
Extra or missing teeth. Another potential contributing factor to an overbite is the number of teeth. The teeth nearby may shift from their usual alignment as a result of missing teeth. Crowding, or having too many teeth for the size of your mouth, can change the position of your teeth. Some teeth may move forward as a result of crowding.
Cysts or tumors. Tumors and cysts in the mouth or jaw can change the form of the jaw and the position of the teeth, albeit this is not a frequent cause of protruding teeth. Growth in the upper jaw may cause the upper teeth to shift forward and protrude from the mouth in some circumstances.

Protruded Mouth Symptoms

Depending on the type and degree of their problem, people with protruded mouths might experience a wide range of symptoms. Typical protruded mouth symptoms include:

Your upper, lower, or both jaws may protrude.
Temporomandibular joint disorder (TMJ).
Erosion of teeth.
Jaw clenching.
Underbites and overbites.
A misaligned jaw.
Misaligned teeth.
Chewing difficulties.
Speech issues.
Breathing problems.

Protruded Mouth Self-Diagnosis

It might seem funny to ask, but from the viewpoint of a plastic surgeon, a mouth that protrudes slightly might not be regarded as anatomically significant. Therefore, you should first confirm that your mouth protrudes noticeably before assuming that it is affecting your facial symmetry and that surgery to repair it is necessary. Here are a few rules-of-thumb or basic criteria to see if this is the case:

The straight ruler test. If you hold a straight ruler with one end on the tip of your nose and the other hanging vertically downward, the ruler should preferably touch the tip of your chin or, if you have a long or strongly protruded nose, it should only touch the tip of your nose. However, you can be regarded to have a protruded mouth if the ruler reaches your mouth.
The closed mouth test. A healthy mouth should close completely without requiring any effort from your lips. If your lips are relaxed but your mouth does not fully close, you may have a protruded mouth.
There is a telltale sign that you are overworking your lip muscles. creases on the chin or the sides of the lips. This is especially true if you are not habituated to having your lips relax (as you have always made an involuntary attempt to keep your mouth closed). Therefore, you may tell whether you have a protruded mouth if you are unable to fully close it without these lines appearing on the chin or lips.
A gummy smile. If your gums protrude significantly when you smile, this is frequently related to an outwardly protruded mouth.
Your nose appears flat in comparison to the rest of your face, and your lips appear thick. This does not necessarily suggest that you have a protruded mouth because these conditions may be met even if you do not because of a combination of a flat nose and thick lips.
Your chin appears to be receding in relation to your mouth. This is also not a very strict test because this condition can be met even if you do not have a protruded mouth but rather a receding chin. Your mouth appears to be protruding in this situation compared to the chin even though it may not be relative to the nose and the remainder of the face.

Protruded Mouth Surgery

Only orthodontic treatment is used to treat mouth protrusions that are not severe in these cases. The front teeth are typically pushed into the space left by the back teeth that are situated behind the canine teeth. Any crooked teeth can also be corrected concurrently over the one and a half to two-year treatment course.

To determine the underlying reason for the protruding mouth and organize a corrective operation, every patient will need to undergo a 3D CT scan. After reviewing the CT scan findings, the surgeon will be able to provide a precise diagnosis and recommend the best method for fixing the issue. There are two primary methods for addressing a projecting mouth:

Anterior Segmental Osteotomy (ASO)

When only the gum is protruding and the teeth are straight, this procedure is used. Under general anesthesia, this treatment typically lasts one to one and a half hours.

Two premolars (two upper and two lower) located behind canine teeth will be carefully removed. A cut and repositioning of the gum bone will take place. The surgeon will next reverse the gum's protrusion by pushing the teeth and gum that are sticking out into the area where the teeth were taken.

This method can assist in repositioning the protruding gums up to 7-8 millimeters back. For roughly 6 months, orthodontic therapy is necessary to fill the empty space.

Two Jaw Surgery with ASO (Three Jaw Surgery)

When the chin is short or receding and the mouth is severely protruding (bimaxillary protrusion), this surgery is advised.

It typically takes 1-2 hours to perform this operation while under general anesthesia.

The lower jaw bones in this treatment will be cut and shifted forward to repair the receding chin after an anterior segmental osteotomy (ASO) is initially performed as previously mentioned. The bones will be fixed with surgical pins. The three-jaw procedure will simultaneously address a protruded mouth and a receding chin.

Protruded Mouth Surgery Advantages

Anterior Segmental Osteotomy (ASO)

A protruded mouth can be fixed with just one straightforward surgery, and the outcome is visible just one to two weeks following the procedure.
Compared to other facial shaping procedures, swelling is typically minimal. After two to three days, the patient can resume their regular routine.
With relatively little trauma, this treatment can significantly alter your appearance.

Two Jaw Surgery with ASO (Three Jaw Surgery)

This operation is more extensive than just an ASO surgery because it can simultaneously repair a protruded mouth and a receding or weak chin.
More facial symmetry can be achieved overall with this procedure than with simply an ASO procedure, and it even has the potential to lift the nose without undergoing any true nose surgery.

Protruded Mouth Surgery Risks

Protruded mouth surgery carries several dangers, just like any major procedure. Common surgical hazards include anesthetic risks, bleeding risks, and infection risks. The hazards associated with this surgery are different. Among those dangers are:

Damage to your teeth
Your bones do not heal properly.
Your jaw joint is giving you problems.
You are unable to fully open your mouth as you would like.
After surgery, your lower lip and cheeks are still numb.
If your initial surgery didn't address all of your issues, you might require another surgery.
You could experience a recurrence of the protrusion that led to your surgery.
You may have scars.

Protruded Mouth Surgery Recovery

Anterior Segmental Osteotomy (ASO)

ASO surgery is a cosmetic procedure with a short recovery time.

For a few days following surgery, moderate pain is typical. After two weeks, patients can resume their normal routines, however, it is advised that they avoid vigorous activity for at least six weeks.

For the first two weeks following the treatment, it is strongly advised to have soft foods and healthy beverages such as thin rice gruel, fresh juice, unsweetened milk, and drinkable liquid foods since they may be easily chewed and reduce pressure and swelling around the jaws.

One week following the procedure, the patient must see the doctor to make sure there are no problems or oral infections.

Two Jaw Surgery with ASO (Three Jaw Surgery)

As a result of this surgery's greater complexity compared to ASO, the patient's return to normalcy will take longer.

After the surgery, the patient will need to stay in a hospital for at least two days.

Immediately following surgery, ice packs must be used continuously. Until the doctor sees you the following morning, the bandages on your face should also be kept in place.

Since the jaw bones are not generally fixed together, it is advisable to eat soft foods. After undergoing a 3D CT scan to ensure there are no problems, the patient can be discharged from the hospital. Stress or physical exertion that is too strong should be deliberately avoided. After 8-10 days, the sutures can be removed.

Mouth Protrusion Surgery Cost

Protruding mouth surgery might cost between $12,000 and $20,000 if health insurance is not used to pay for the treatment. Although a protruded mouth is often fixed to enhance one's look, in rare instances where it is shown to contribute to dental malocclusion or misalignment (abnormal bite), which can then cause difficulties with eating or digestion of food, it may be covered by insurance.

Costs differ depending on the surgeon, the location, and the complexity of the treatment.

Conclusion

From preoperative planning through the completion of the surgery, mouth protrusion surgery depends on tight cooperation between the surgeon and the orthodontist. Preoperative planning and dentofacial deformity evaluations are made more accurate using virtual computer planning. Additionally, it is a crucial tool for giving thorough patient education.