Whether braces make the lips stick out is a common concern for people considering orthodontic treatment. Braces often create a temporary effect of lip protrusion, which is a purely mechanical consequence of the hardware being placed in the mouth. Ultimately, the long-term changes to the soft tissue profile, including the lips, are determined by the underlying tooth movement and the specific goals of the treatment. For many patients, the final result is a more balanced and harmonious facial appearance.
The Immediate Effect of Brackets and Wires
When fixed orthodontic appliances are first bonded to the teeth, they introduce an immediate physical bulk between the teeth and the inner surface of the lips. The brackets, bands, and archwires occupy space, pushing the soft tissues of the lips slightly outward. This instant effect can make the lips appear fuller or more prominent than they were before the hardware was placed.
This temporary protrusion is a purely mechanical reaction to the volume of the appliance, adding a few millimeters of thickness to the dental arch. This initial fullness is not a permanent change to the structure of the lips but rather a displacement. The feeling of “puckering” or having the lips stick out is most noticeable immediately after the braces are bonded.
Orthodontic Tooth Movement and Profile Change
The lasting change to the lips is caused by the therapeutic movement of the teeth, not the hardware, which modifies the underlying skeletal support. The teeth provide a foundation for the lips, and their repositioning directly influences the soft tissue profile. Orthodontic treatment often retracts the front teeth backward to correct protrusion or crowding.
When the front teeth are moved inward, the soft tissue of the lips is pulled back and supported in a less prominent position. Studies show that for every millimeter of horizontal movement of the upper front teeth, the upper lip may move backward by about 0.5 to 0.6 millimeters. This retraction can significantly flatten a convex profile, resulting in a softer and more aesthetically pleasing facial balance.
Conversely, if the front teeth need to be moved slightly forward to create a more supported smile or correct an underbite, the lips may become slightly more prominent. The long-term profile change results from forces acting on the teeth and the alveolar bone (the bony ridge that holds the tooth sockets). The soft tissue response is not always linear and can be influenced by the perioral muscles and the initial thickness of the lips.
Factors Influencing Lip Appearance During Treatment
The degree to which the lips are affected during treatment depends on several variables, starting with the type of appliance used. Traditional metal or ceramic braces, which are bonded to the front surface of the teeth, create the most immediate bulk and temporary protrusion. Alternatives like lingual braces, which are placed on the tongue-side of the teeth, or clear aligners, which are much thinner, minimize this initial mechanical effect.
The patient’s initial anatomical structure, particularly lip thickness, also plays a role in the visible change. Patients with naturally thinner lips may notice the protrusion effect of the hardware more dramatically than those with thicker lips. The specific treatment plan is a major determinant of the final outcome.
Treatment goals that involve extracting teeth, typically premolars, allow for a greater degree of incisor retraction, leading to a more pronounced reduction in lip prominence. Non-extraction treatments, where space is created by widening the dental arches or mild forward movement, generally result in less profile change. The orthodontist uses these different approaches to achieve the desired balance between the teeth, the jaw structure, and the overlying soft tissues of the face.
Resolution and Final Facial Outcome
The temporary protrusion caused by the bulk of the brackets and wires disappears instantly once the orthodontic hardware is removed. The soft tissues of the lips immediately settle back against the newly positioned teeth, ending the mechanical displacement effect.
Following the active phase of treatment, the lips and surrounding soft tissues begin to adapt to the new dental and skeletal foundation. The final aesthetic result includes a “settling” period where the lips relax into their corrected position. The profile change achieved through the movement of the teeth is permanent and represents the therapeutic goal of the treatment.
In cases where the teeth were significantly retracted, the final outcome is a reduction in the initial lip prominence, leading to a flatter and more harmonious profile. The long-term effect is positive, as the orthodontic correction contributes to a more balanced and attractive facial appearance that lasts well beyond the removal of the braces.