An adult in their mid sixties with moving anterior teeth almost always has a component of gum disease and missing teeth. I have not seen you, or radiographs or models. What you are describing (wider gap, outward leaning teeth) is what in our profession calls loss of posterior support and anterior collapse. We only have two kinds of teeth back ones are the column and studs that keep the building standing and square, front ones are doors and windows which as long as the building is stable work and look the same, but cannot carry the load of columns and studs. And if they are missing, front teeth quickly disappear. It will take an adult with gum disease and cavities 30-40 years to lose their back teeth, front teeth will go in 3-5 years. And you end up gluing your teeth in.

Which came first the chicken or the egg? A large tongue, or tongue thrust can make your teeth flare out. Gum disease can lead to bone loss and shifting of the teeth. So which led to which? A competent dentist should be able to diagnose a tongue thrust and refer you for treatment. A large tongue cannot be made smaller, but makes me wonder about sleep apnea which can affect many health issues. Get is checked out.

The most likely diagnosis from a dental perspective would be bone loss around these teeth fro periodontal disease. this would cause eventual loosening of the teeth and displacement leading to gaps.

It your tongue is truly enlarging causing pressure against the teeth, there are many potential causes. Included would be thyroid disorders, which you have probably already ruled out. Also to be considered would be sarcoid and amyloid. There are studies that could be done to help determine this. You may have other symptoms that could be tied in with this tongue issue. Medications that you are taking may also cause some of these tongue symptoms either by actual enlargement or the effect on the tongue muscle. You may wish to revisit this with your physician or perhaps also visit your closest medical/ dental school that has an oral surgery and oral medicine department to better evaluate your situation assuming it is not just periodontal disease.

Medications for gastrointestinal problems and depression can cause movement disorders that can involve the tongue. Providing your doctors with a list of your medications and other symptoms will help them in the diagnosis. Most likely, the dental changes are caused by tongue thrusting and not macroglossia (enlarged tongue). Tongue thrusting exerts pressure on the lower teeth and can cause the lower teeth to procline (i.e. flare out), increasing the spacing. Your dentist can treat you or refer you to specialists to treat the bone loss. Once the periodontal disease is under control, orthodontic treatment can correct the spacing. As others have suggested, a university hospital or clinic would be a good resource.

obviously there are changes in arch support that can contribute to tongue thrusting and vise versa. in cases of bone loss, although is fairly common in this age group especially when family history is present, would suggest to have the primary care MD informed as well. dental professionals with experience in adult ortho/perio as well as oral medicine experts should be at the fore front of treatment

In follow-up: I see that you are in Minneapolis. University of Minnesota has an oral medicine department. I would suggest you try to see Dr. Nelson Rhodus, a professor in that department. Good luck again.

Tongue enlargement ("macroglossia") is controversial. In most situations the tongue is not enlarged, but changes in saliva or salivary gland function can result in sensations of the tongue enlarging. Individual anatomy can create tongue or jaw positions in which the tongue appears abnormally large. There are no tests that can measure tongue size to detect changes; nor are there established norms against which to compare. One medical condition that can produce tongue enlargement, as well as spreading of the teeth (although usually the upper teeth) is acromegaly, which results from abnormal pituitary function (not thyroid)...this unusual disease has other signs and symptoms as well, and your physician can assess for it. Thyroid dysfunction would be unlikely to produce the symptoms you describe. However, parathyroid dysfunction, specifically hyperparathyroidism, can produce bone loss in the jaws. Again, there would likely be other symptoms as well ... fatigue, nausea, bone pain, kidney stones are some that are possible...and again, your physician could assess for this. If your periodontal condition is OK, and your dentist cannot identify a dental cause, a good internal medicine work-up would be appropriate. Another option would be to consult with the Oral Medicine Department at a dental school, if you live near one, or visit the American Academy of Oral Medicine website www.aaom.com) to find a member doctor who practices near you. Thank you for a very interesting question. Good luck.

There is no second thought that you need to be evaluated by Endocrinologist to rule out any systemic effect

on the enlargement of your tongue but side by side as i wrote to you earlier that you might have periodontal condition and might need treatment ..This retainer which is removable will only help you to prevent further movement of teeth but once these teeth are periodontally treated and brought back more lingually ( Inside ) by teeth movement technique ( Invisalign or fixed Ortho ) the gap between teeth will be reduced which will reduce the stimulation for the tongue to press against the spaces . The permanent fixed splinting of anterior teeth will be necessary to prevent ant teeth movement but will be done once the teeth spacing is reduced.

Usually patients with periodontal condition feel better on the tooth when they squeeze their teeth and your tongue keeps going back against your loose front teeth because the pressure from the tongue on the teeth makes you feel better . The constant pressure on your tongue may be a cause for enlargement of your tongue .You must rule out every possibility .

The tongue "enlargement" you describe is likely unrelated to any disease process, including edema or amyloid or angioedema, or thyroid disease. Sometimes tongue pressure and thrusting forces teeth forward and destroys bone and teeth "lean" forward. This is likely what is happening. As the teeth move, the tongue will "follow" forward, causing the appearance of further "enlargement". Angioedema is a sudden increase in tongue size often associated with an allergic reaction or certain drugs, but sometimes due to a blood protein deficiency--"hereditary" angioedema. In either case, angioedema is an acute, not a chronic problem and often requires urgent management with special medications. It doesn't sound like what this is, but an exam by an oral surgeon is in order.