Would extracting four premolars be detrimental to my facial profile? (photo)

I see patients every single week in my practice who are devastated by the adverse effects of bicuspid extraction therapy. There are NUMEROUS studies on identical twins with one twin treated using bicuspid extractions and the other using non-extraction treatment. At the end of treatment they no longer look like twins and without exception the more attractive twin is the one treated with non-extraction. If you want a long, narrow face, go ahead and extract teeth, if you want a broad, beautiful smile, leave the teeth in. You have no need to extract teeth and are a perfect candidate to develop arches. You also have extra space from your retained lower baby tooth as it is wider than an adult bicuspid. I would DEFINITELY not recommend extracting any of your bicuspids and I can refer you to numerous people who have had bicuspid extractions who would be more than happy to convince you to leave your teeth in your mouth where they belong.Good luck!

Done correctly there are no good scientific studies that show that extractions cause poor profiles or tmj type problems.  Those who tell you that they do are just trying to scare you into doing things "their way" .Their way being non-extraction treatment no matter what!