Will Lips Change After Braces And Extraction Of Protruding Teeth?

Question

Will a persons top lip (and area between their mouth and nose) get smaller after extraction and braces are used to fixed protruding teeth?

Robert Waxler, DMD, MS · Answer

In general the upper lip moves back 1/2 the distance the upper teeth move back.....remember however that, if your teeth were crowded, much of the extraction space was already used to correct the crowding so the teeth move back less than the full space.

	Lip and facial esthetics should always be factored into the decision to extract teeth, but sometimes it is the best option

Sam Veshkini, DMD · Answer

When extraction is recommended by your orthodontist to correct protruded teeth, as the upper teeth go back, the lips also go back. However; if there is a lot of crowding, there will not be much change on the profile.

Steven Jay Bowman, DMD, MSD · Answer

You have received a number of excellent answers from other practitioners. Final lip position is not strictly a function of whether extractions are performed. In fact, more protrusive lips can be produced even with extractions depending upon the biomechanics employed and the goals determined for treatment. If retraction of the teeth to reduce protrusion is desired, then some degree of lip retraction is likely to accompany the teeth. There have been a number of studies attempting to determine the predictability of the amount of this lip change that have demonstrated varying success. In 2005, workers from Brazil and U.S. published a study of upper first premolar extraction patients and again found only mild predictability, but on average there was about 0.7 mm of lip retraction for each 1.0 mm of front tooth retraction. Interestingly, enough, these changes are most often determined to be esthetically pleasing in these types of situations where patients desire reducing the protrusiveness of their front teeth.

Brian Povolny, DDS, PhD · Answer

In general the upper lip is supported partially by the upper front teeth. So anything that moves the front teeth back can move the upper lip back. However, each case is unique. Sometimes extracting teeth might not have much affect on the upper lip, depending on factors like how much dental crowding there is, how protrusive the front teeth are, or exactly which teeth (first vs. second bicuspids) are extracted. I would suggest discussing these issues with an experienced orthodontist to get answers about your case.

Henry Fung, DDS · Answer

The contour of the face and lips rely on two things:

	
		bone structure (the maxillary and mandibular bones, aka cheek bones and jaw, and teeth)
	
		facial tissue (the muscles and fat)


	Just like people who have taken out the full dentures have their face shortened and lips caved in, protruding and misaligned teeth gives the face an uneven and unbalanced profile. 

	Braces (orthodontic treatment) not only aligns the teeth for functional purposes but also cosmetically enhances the facial features to give a balanced and even look.  Under different circumstances and goals, a dentist would extract protruding teeth followed by braces to fill in the gaps or realign them with the rest of the teeth.

Greg Jorgensen, DMD, MS · Answer

The amount of change in you lip position after orthodontic treatment, especially after the removal of teeth, is dependent upon many factors. If you have crowding in the arches, you many not notice any lip change at all. If you have big, full lips you may not notice any difference at all. The real changes take place if your teeth are protruding and not crowding. Moving them back will give you some improvement. At minimum you won't see the lips move further forward and look more protrusive as sometimes happens if you do not remove teeth. The key to a successful outcome is a thororugh diagnosis by an experienced orthodontist. Not removing teeth when necessary can be just as bad as removing teeth when is it not appropriate. Good luck!

Doug Depew, DMD, MS - Account Suspended · Answer

Sometimes orthodontists need to remove some bicuspid teeth in order to either align the front teeth, move the front teeth backwards, or both.  The amount of change in the profile can be beneficial in many cases. But it can also be detrimental if done on the wrong kind of case.  How much retraction happens depends on several factors including how much crowding or overlapping is present, the patient's desire for a profile change, and the doctor's skill and mechanics used.  A skilled doctor can often control how much retraction happens in order to give you a pleasing lip profile. 

	Although this type of treatment is sometimes necessary or at least highly recommended, it should not be taken lighthly.  A thorough diagnosis by an expeirenced orthodontist is essential.  This includes making of photographs, at least two x-rays, and models of your teeth.  This is standard of care for a proper treatment plan.

	Again, check out the linked video.  Good luck!

Lawrence Singer, DMD (in memoriam) · Answer

Your lip position can definitely change dramatically with orthodontic movement. A good dentist will be able to visualize this and may be able to help communicate the results to you through computer imaging. In assessing a patient for orthodontic treatment there are two issues 1) What is the bit result we are going for - a perfect bite? 20 What are the implications of the aesthetics of the soft tissues and the changes to the facial appearance that will result from the movement of these teeth. Often it may not be advisable to try to achieve a perfect bite where the teeth fit together perfectly if it compromises aesthetics. There are too many cases where braces have been overdone to achieve a perfect bite and the result is a sunken in looking face with lips that drape too much and a smiles that doesn't show enough teeth

Will Lips Change After Braces And Extraction Of Protruding Teeth?

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