Short answer: Braces change the alignment and bite of the teeth, not the bone structure of the face. When the position of the front teeth changes, lip support and the side profile can be affected somewhat; this difference is generally on the order of a millimeter and varies from person to person according to lip thickness, age and the treatment plan. In marked jaw discrepancies, braces alone may not be enough, and a surgical assessment may be needed.
One of the first questions on the minds of many people who come for an orthodontic exam is this: do braces change face shape? The short answer is that because the position of the teeth and the soft tissues attached to them changes, some differences can occur in the lower third of the face, but this difference varies greatly from person to person. Bone structure, the growth period, lip thickness and the treatment plan are the main factors that determine the result. In this article we cover the possible effects on the lips, profile and jawline, together with realistic expectations.
Do braces change face shape?
Braces do not change the general skeleton of the face; they primarily change the alignment and bite of the teeth, and the effect seen on the face is the reflection of this change in the soft tissue. Areas such as the nose, cheekbones and forehead are not affected by orthodontic treatment. The area where an effect may be seen is the region between the lips, the area around the lips and the tip of the chin.
For example, upper incisors that tilt forward push the upper lip out. When these teeth are moved back, the lip can also come back somewhat. Conversely, when inward-tilted teeth are moved forward, lip support can increase. However, how closely the lips follow the teeth is individual; thick, taut lips reflect the change in the teeth less, while the difference may be more noticeable in thin lips.
For this reason, orthodontists look not only at the teeth but at the whole face when planning. The aim is not to upset the balance of the face while straightening the teeth, and if possible to support it.
How are lip support and profile affected?
Lip support depends largely on the angle and position of the front teeth; when the position of the front teeth changes, the line of the lips seen from the side can change as well. In a profile assessment, the relationship between the tip of the nose, the lips and the tip of the chin is examined.
- Protruding lips: When the teeth tilt too far forward, it can be hard to close the lips. Bringing the incisors to a suitable position can help the lips close more comfortably.
- Lack of support: When the teeth are tilted inward, the lips can look set further back. In these people, moving the teeth slightly forward can increase lip support.
- Smile line: When the dental arch widens or levels out, the amount of tooth visible when smiling can change.
Orthodontic profile change is generally on the order of a millimeter. Because a person looks in the mirror every day, they may not notice the difference right away, while people around them may get the impression that "something has changed." What matters is that the change is in harmony with the face's own proportions.
Jawline and lower face: teeth or bone?
What mainly determines the jawline is not the teeth but the size of the lower and upper jawbones and their position relative to each other. Braces move teeth within the bone, but they do not change the size of the jawbone in an adult.
In orthodontics, some problems are "dental" in origin and some are "skeletal." In dental problems, the alignment of the teeth is off but the jaws are in harmony with each other. In skeletal problems, one of the jaws is forward, set back or asymmetrical. This distinction is made by assessing the bite classes and it sets the limits of treatment.
In marked skeletal differences, braces alone can "camouflage" the teeth; that is, the teeth are positioned so as to partly hide the mismatch between the jaws. If the difference is larger, jaw surgery (orthognathic surgery) may come up together with orthodontics. This decision is made with care, based on detailed records and an exam. You can read about approaches specific to a set-back lower jaw on our page on treatment of a recessed lower jaw.
Another point regarding the jawline is soft tissue and age. With age, skin elasticity decreases and the lips thin. This natural change can sometimes be confused with orthodontic treatment; yet the same process occurs in people who have not had treatment.
Does treatment with tooth extraction hollow out the face?
A treatment with extractions that is properly indicated and well planned generally does not hollow out the face. The worry about this comes from the idea that closing the extraction spaces will pull the front teeth back and the lips will go back too far.
Scientific assessments show that the effect on the profile is related less to the extraction than to the starting lip position, the angle of the teeth and how the spaces are closed. For example, in a person whose lips already protrude, an extraction can help the lips close more comfortably. In someone with a flat or recessed profile, the doctor may bring non-extraction options further to the front.
In short, the decision about extraction is made separately for each patient. You can also take a look at our article on when tooth extraction is needed in orthodontic treatment, where we cover this topic in detail.
Expected difference in adults and children
The change that can be seen in the face of children and adolescents can be broader than in adults, because the jaws are still growing at this stage. In a growing child, the development of the jaws can be guided with some appliances; for example, functional treatments that support the forward development of the lower jaw are used for this purpose.
In adults, since growth is complete, the bony structure cannot be changed; treatment works through the position of the teeth. For this reason, the effect on the face in adults is mostly limited to the area around the lips. Even so, resolving crowding, correcting the bite and closing the lips comfortably can contribute to a more balanced facial expression.
- In children: There is an opportunity to guide growth; timing is important.
- In adolescents: Some skeletal problems can be addressed more effectively during the growth spurt.
- In adults: Change limited to tooth movement is expected; in marked skeletal differences, a surgical assessment may be needed.
The same biological principles apply to treatment with clear aligners. It is not the type of appliance that moves the teeth but the planned tooth movement that determines the effect on the face.
Is it possible to see the change in advance?
Tooth movements can be planned and visualized in advance, but it is not possible to predict with certainty how the soft tissue will respond. At the planning stage, records such as an intraoral scan, photographs and, if considered necessary, a cephalometric X-ray are taken.
With a digital intraoral scan, the target position of the teeth can be simulated in three dimensions. This simulation is useful for understanding how the teeth will line up. You can reach the digital tools we use at our clinic on our page on our technology. However, the final form of soft tissues such as the lips and the tip of the chin differs according to a person's tissue structure; for this reason, simulations should be regarded as a tool for estimation.
It helps to ask your doctor these questions at the exam:
- Is my problem dental or skeletal?
- How might the planned tooth movements affect the position of my lips?
- How do the extraction and non-extraction options differ in my case?
- Is a surgical assessment necessary?
These questions help you understand realistically what to expect from treatment. For other things people wonder about the treatment process, you can also look at our article on how long braces pain lasts.
Orthodontic assessment in Ankara
If you are curious about the balance of your lips and profile along with the alignment of your teeth, an orthodontic exam is the healthiest place to start. At our clinic in Park Oran Ofis in Çankaya, our orthodontist assesses your facial structure, bite and teeth together and explains the options specific to you; the possible effect of treatment on your face is also discussed openly at this consultation. You can use our contact page to book an appointment.
Frequently asked questions
Do braces make the face thinner?
Braces do not change the fat tissue or the bone width of the face. There may be weight changes in the first weeks of treatment due to eating soft foods, but this is not an orthodontic effect. Changes around the lips depend on the position of the teeth and differ from person to person.
Do braces bring the chin forward?
In adults, braces do not change the size of the jawbone. In some cases the position of the lower jaw may change slightly as the bite is corrected, but in a marked recessed jaw, surgical options may come up. In growing children, appliances that guide jaw development can be used.
Do the lips sink in after treatment with extractions?
In properly planned treatments with extractions, the lips are not expected to sink in noticeably. The effect on the profile depends on the starting lip position, the angle of the teeth and how the spaces are closed. The decision about extraction is assessed separately for each patient.
Do clear aligners and braces affect the face differently?
What determines the possible effect on the face is the planned tooth movement, not the type of appliance. When the same tooth movements are made, a similar soft tissue response is expected. Which method is suitable is determined at the exam.
