Can I Improve my Profile by Having Orthodontic Treatment? (photo)

Question

My profile is horrible. I constantly feel a tension around my jaw because I can't close my mouth without forcing it. People always say I'm upset by look while I'm not, it's just my mouth. I have crowded and crooked teeth. I consulted with three orthodontists and they do not suggest extraction, most do not care my profile problem. One ortho's plan is Invisalign distalization to not make my profile fuller but says my lip incompetence will not change for better. How about TAD with non-extraction?

Vijay Bhagia, DMD · Answer

Hi

	Your pictures are not at rest. You are pursing your lips so it is hard to see the extent of the problem. Pictures are not able to show the whole problem anyways because we have to see animation.
	You have a vertical problem more than anything which might be addressed with TADs for posterior intrusion or with surgical impaction of the maxilla. You are a young girl and you should be able to smile for the rest of your life. Invisalign and TAD distalization is perhaps not ideal. 

	I am going to encourage you to go seek more personal opinions.

	Vijay Bhagia, Space Center Orthodontics, Houston, TX

Robert Waxler, DMD, MS · Answer

It looks like your problem is more vertical than horizontal...in other words your upper jaw is hanging down too far (which is why you show so much upper gums) This in turn also causes your lower jaw to stop rotating earlier than ideal as you close, and thus making your lower anterior facial height long ...so you have difficulty in closing your lips together.

	The problem is that the only way to significantly change vertical problems is surgery of the jaw...a pretty big deal!

	But expanding the arches to take care of crowding only makes your profile worse . Often people who only want or use Invisalign tend to avoid extractions that are the only way to achieve enough room to retract protrusive teeth

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