Lack of space in the dental arches is a daily problem faced by by many patients who have had orthodontic extractions at a young age. In your photos I see you had premolar extractions. Despite the fact that the extractions immediately create more space which allows for orthodontic alignment, they can lead to negative outcomes that are frequently ignored. EXTRACTION OF TEETH FOR ORTHODONTIC TREATMENT CAN LEAD TO: 1) Less support for the upper lip. As the teeth are pulled back after the extractions, the facial profile becomes less attractive (flat face, flat cheeks, nose sticking out), which can result in wrinkles and lines and overall aged appearance. 2) Less space for the tongue. The arches become smaller, forcing the tongue to take a backward position, leading to blockage of the throat (airway), snoring and increased risk for mouth breathing. Breathing through the mouth is very bad for oral and general health. 3) Higher risk for sleep apnea. With the restricted space, the tongue fully relaxes during deep sleep, blocking the entrance of air and leading to interrupted sleep due to poor breathing. With low oxygen intake and chronic sleep deprivation, there is more risk for hypertension, heart disease and diabetes. 4) Higher risk for chronic pain and functional issues. In retracted arches, tongue can end up on top of the lower teeth; this can create and worsen bite issues that can lead to migraines, headaches, neck aches, ear problems, problems in the jaw joints, limited opening of the mouth, sinus issues, posture problems, etc. POSSIBLE SOLUTION: Through another round of orthodontics, the space of the extracted teeth can be reopened along with other possible spacing to procline the smile teeth while expanding the dental arches. This can increase airway and tongue space, solving all breathing and space issues and increasing overall balance in the mouth, wellbeing and life quality. This, many times, be done through clear aligner therapy or with conventional braces. After opening the spaces, a cosmetic dentist can restore function and cosmetics with the use of veneers, bonding, implant and crowns.