Facial changes after braces (Photo)

I had braces for two years and my orthodontist had 4 of my teeth remove. My two upper first premolar and my two bottom first premolar. My face was fuller, i had a big and full smile. After my treatment i feel like my face is way slimmer, and it looks like my chin is more pointy. My teeth is tiny and Is like i aged 20 years. I was wondering if i can get some fillers or some sort of treatment. And will veneers help or not?

Doctor Answers 2

Premolar extraction

Hi, anna_2016!

Thank you for your question and photos! First, congrats on finishing treatment and your new smile! It looks like your finished result is excellent from the photo.

Premolar extractions like you had are relatively common in orthodontics. Orthodontists have been recommending extractions for 75 years to improve the alignment and relationship of the teeth. Peer-reviewed research has confirmed the benefit and low risk to premolar extractions with an orthodontic specialist. It's impossible to say without full initial records, but based on the photo you've provided it does look like you started out with some severe crowding of the upper teeth. Most orthodontists would recommend extractions in this situation.

When severely crowded teeth are aligned without extractions teeth can be pushed out of the bone. When this type of movement occurs you're at a greater risk for periodontal problems like recession which can weaken the tooth. To align the front teeth and keep them in bone, extractions of posterior teeth (like premolars) are occasionally recommended.

Please discuss any questions about your treatment or results with your orthodontist and I'm sure you'll be pleased with any additional options available.


Irving Orthodontist

Facial Changes After Bicuspid Extraction Orthodontics

I am very sorry to hear you are not happy after completing orthodontic treatment. You should have been able to trust that the recommended treatment was best for you. Unfortunately, many orthodontists still believe that bicuspid extraction orthodontics is sound treatment. I have written extensively on this subject here on Real Self and other places. I would invite you to read what I have written previously. Bottom line is you are 100% correct in your self-assessment. Bicuspid extraction therapy creates long, narrow faces. It creates narrow smiles and small lips. It can damage TMJ's and airways. It makes the nose look bigger. It causes wrinkles around the corners of the mouth. It creates a concave facial profile. In short, it compromises facial aesthetics, TMJ's and airways. If all you are concerned about is having straight teeth then bicuspid extraction orthodontics will work but if you want straight teeth AND a more attractive face then bicuspid extraction orthodontics is ALMOST NEVER the best treatment option.There was a study done years ago where identical twins went through orthodontic treatment at the exact same time. One twin was treated with bicuspid extraction therapy and the other twin was treated using more modern techniques. At the conclusion of treatment the twins no longer looked identical and looked so different that they could hardly be identified as sisters, much less identical twins. Guess which of the two identical twins was clearly more attractive...
What can you do now that you have had this type of treatment? There are some things you can do to "undo" your treatment but they are not as simple as "filler" or veneers. You basically have to undo the treatment that caused the problems you are noticing. This can be done with a simple, comfortable, removable dental appliance. Unfortunately, there is no quick fix but you will be much happier with the results. Look for a doctor who understands the relationship between orthodontic treatment and facial aesthetics and TMJ/airway health. Find a doctor who understands epigenetic orthodontics. The solutions are not simple but are certainly worth your effort.
Good luck!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.