I had braces for over a year now. My treatment is almost over, but I think my mouth is still protruding. Why? (Photo)

Question

I had braces for over a year now but my mouth is still protruding. I already had one upper left & one upper right premolar tooth extracted. My treatment is almost over but I still have a protruding mouth and receding chin. Is there any further treatment/procedure to resolve this. Even if I try to push my chin forward I still have a protruding mouth and receding chin. I was told by my orthodontist that is how I would look like if I had the jaw surgery - see last photo . Thank you

Miller Vieira Paula, DDS · Answer

Your concerns about a protruding mouth and receding chin despite orthodontic treatment are valid, especially since your treatment is nearing completion. Here’s an overview of what might be happening and possible options:
Possible Reasons for Your Concerns:
Protrusive Lip Posture:Even after extractions and orthodontic alignment, the protrusion might be due to the natural anatomy of your jawbones, lips, or soft tissue. Orthodontic treatment alone primarily addresses teeth alignment, but it may not significantly change the facial skeletal structure.
Receding Chin:A weak or receding chin (retrognathia) may contribute to the appearance of a protruding mouth, especially when viewed from the side. This is usually related to skeletal structure and not tooth alignment.
Soft Tissue Adaptation:The lips and surrounding soft tissues may not have fully adapted to the new tooth positions, which can take time after treatment ends.
Incomplete Correction of Tooth Position:If the orthodontic treatment didn’t adequately retract your front teeth after extractions, this could leave the lips looking protruded.
Possible Further Treatments:
Orthodontic Reassessment:Discuss with your orthodontist if more retraction of the front teeth is possible. This might require additional anchorage techniques such as Temporary Anchorage Devices (TADs), which can provide stronger support for moving teeth further back.
Orthognathic Surgery:If the underlying issue is skeletal (such as a small lower jaw or an overly prominent maxilla), orthognathic (jaw) surgery might be necessary to reposition the jaws. This can improve both the protrusion and the chin appearance.
Chin Augmentation:A chin augmentation procedure, such as a genioplasty or the placement of a chin implant, can help balance your profile by making the chin more prominent and reducing the appearance of a protruding mouth.
Lip and Facial Contouring Procedures:Non-surgical options, such as fillers or Botox, may help contour the lips and chin for a more harmonious facial profile. However, these are temporary solutions compared to surgical ones.
Next Steps:
Consult Your Orthodontist:Discuss your concerns about the protruding mouth and chin. Ask if further retraction of the front teeth is feasible or if surgical options might be appropriate.
See a Maxillofacial Surgeon:A consultation with a maxillofacial surgeon can help evaluate the skeletal aspects of your face and determine if jaw surgery or chin augmentation is necessary.
Get a Second Opinion:If your orthodontist isn’t addressing your aesthetic concerns, consider consulting another orthodontist or facial specialist for a fresh perspective.It’s essential to balance dental function and aesthetics in your treatment plan, so don’t hesitate to explore these options with your healthcare providers.
Dr. Miller Vieira Paula

I had braces for over a year now. My treatment is almost over, but I think my mouth is still protruding. Why? (Photo)

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