Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 11/6/2009

Question
My lips seems to be getting tight in the way that I cannot open my mouth as wide as I use to. The skin seems taught.  I noticed it the last couple of dental appointments when the dental assistants tried to work in my mouth & it felt like they were cranking my lips open & caused horrible pain in the tissues on the inside of the lips. It actually felt like my lips would tear. I have mixed connective tissue disease with pulmonary fibrosis and other weird stuff (like several episodes of meningitis) and well anyway I was at the oral surgeon's yesterday to have an evaluation of something that showed up on an MR in the TMJ. When the tech took an impression it stretched my lips to the point of feeling a tearing pain & it felt like the tissue was ripping inside. Today it is swollen and small swollen places are coming up on the inside where it felt like it was tearing. Will this go away? Is it possible for the connective tissue disease is affecting my mouth like this?? I don't want to complain to the oral surgeon because when he evaluated my mouth he cranked on it as well and it hurt me. I really need the brace they are making as my bite is messing up and I often go for days where only of my back teeth can touch when I close and it is difficult to chew. I have beautiful teeth & otherwise I'm in good shape and work out several days a week. I am 48.

Answer
Cara -  Shrinking lips is not a common problem, but I have seen similar situations in patients with other connective tissue diseases.  There is not simple approach to reversing the process.  I saw one patient who had an appliance made from acrylic and springs that created internal pressure on the lips to expand the mouth.  I did not see her too long, but I heard she did improve.  Who might make such an appliance?  I am not sure.  Stretching of the lips your self by placing gradually increasing size fruits in the opening to your mouth and against against your lips might also help.  You would probably need to moisten the lips first with a creme or vaseling type material to help the stretch.

I wish I could give you a simple cure, but you need to slowly expand the lips and that might help.