Orthodontic treatment, commonly known as braces, involves applying consistent, gentle pressure to teeth to shift them into new positions. A frequent question among those considering this treatment is whether these dental adjustments can ultimately alter the shape of the face. While braces are primarily designed to correct bite issues and align teeth, the resulting changes to the underlying dental structure can indeed lead to measurable, though often subtle, alterations in the facial profile. These facial changes are a secondary consequence of correcting the alignment of the teeth and jaws. The overall impact on appearance is often significant to the individual.
How Braces Influence Bone and Tissue
The ability of braces to influence facial contours relies on the biological process known as bone remodeling. When orthodontic forces are applied to a tooth, they create areas of pressure and tension within the surrounding alveolar bone, which is the specialized bone that holds the tooth roots. On the side of the tooth where pressure is applied, specialized cells called osteoclasts break down bone tissue, creating space for the tooth to move.
Simultaneously, on the opposite side where tension is created, osteoblasts deposit new bone tissue in a process called apposition. This continuous cycle of bone resorption and deposition allows the tooth to migrate through the jawbone while maintaining structural integrity. The bone surrounding the tooth root adapts to the new position, fundamentally changing the structure that supports the soft tissues of the face.
The soft tissues of the face—including the skin, muscles, and fat pads—act like a drape over the underlying bony and dental scaffolding. When the position of the teeth and the supporting alveolar bone is altered, the overlying soft tissues must adapt to the new contours. This adaptation translates dental movement into a visible change in the facial profile. Soft tissue changes are often more noticeable in areas like the lips and cheeks because they are intimately connected to the dental arch.
Specific Facial Features Affected
The most commonly observed change in facial features relates to the lips and their appearance. When front teeth are significantly protrusive, they push the lips forward, creating a convex profile. Retracting these teeth during orthodontic treatment removes this excessive support, allowing the lips to settle back and creating a straighter, less protrusive profile.
The degree of this lip retraction is a direct function of the amount of dental movement, meaning patients with severe initial protrusion experience the most dramatic visual change. Orthodontic correction of an open bite or a deep bite can also influence lip position by altering the vertical dimension of the front teeth.
Changes to the chin and jawline are primarily a consequence of correcting the relationship between the upper and lower jaws, known as the bite. Correcting a severe overbite (Class II malocclusion) often involves bringing the lower jaw (mandible) forward relative to the upper jaw. This repositioning can make the chin appear more defined and project further forward, improving the overall harmony of the lower face.
Conversely, correcting an underbite (Class III malocclusion) often involves moving the mandible backward or restricting its forward growth, which can subtly soften the appearance of a previously prominent chin. Braces move the teeth, and the resulting change in the jaw’s resting position is what alters the visible projection of the chin, which is medically termed the menton.
A common concern involves the cheeks appearing sunken or hollow after orthodontic treatment. This is rarely a direct effect of tooth movement itself but is instead often a perceptual change. When significant dental protrusion is corrected, the area around the mouth flattens, which can make the midface region seem relatively less full by comparison. Any actual loss of facial volume is often related to general weight loss that may occur during the treatment period, rather than a direct mechanical action of the braces.
Factors Determining the Degree of Change
The extent of facial change resulting from braces is highly individualized and depends on several patient-specific factors. The severity and type of the initial malocclusion are significant determinants of the final visual outcome. A patient starting with severe crowding, protrusion, or a major skeletal discrepancy is likely to experience a more noticeable facial change than someone seeking minor alignment corrections.
The decision to perform tooth extractions, typically of bicuspids (premolar teeth), can significantly amplify the degree of profile change. Extracting teeth provides extra space that allows for greater retraction of the anterior teeth, leading to a more pronounced flattening and less convex profile. Non-extraction treatment, which expands the dental arches, tends to result in less profile change or a slight increase in lip support.
Patient age is another factor influencing the potential for change. Younger patients whose facial bones are still undergoing growth can sometimes achieve skeletal changes, meaning the jaw bones themselves are guided into different positions. In contrast, adults are typically limited to primarily dental changes, where the teeth move within the existing bone structure, and facial contour changes rely entirely on soft tissue adaptation to the new dental position.