The decision to pursue orthodontic treatment often raises a question beyond achieving a straight smile: Does getting braces change your face shape? While the primary goal of orthodontics is dental alignment and bite correction, the teeth and jaw are structurally intertwined with surrounding facial tissues. Therefore, any shift in the dental structure inherently influences the appearance of the lower face.
The Direct Answer: How Braces Influence Facial Structure
Braces change the position of teeth, and since teeth are anchored within the jawbone, this movement triggers a biological process called bone remodeling. When gentle, continuous pressure is applied by the orthodontic appliance, bone is dissolved on one side by osteoclasts and new bone is deposited by osteoblasts on the opposite side. This allows the tooth to gradually move through the jawbone.
This dental-skeletal interaction means that tooth movement causes the surrounding alveolar bone—the part of the jaw that holds the tooth sockets—to reshape. Since soft tissues of the face, such as the lips and cheeks, are supported by this underlying bone, any change in the foundation can subtly alter the facial contour. These changes are most noticeable in the lower third of the face, around the mouth area.
Specific Changes to the Lower Face and Profile
The most common and aesthetically significant changes occur in the soft tissue profile, which is the side view of the face. Correcting an overbite, where the upper teeth protrude excessively, often involves moving the upper front teeth backward. This retraction causes the upper lip to settle back, making the profile appear less convex and the lips less protrusive. Conversely, correcting a severe underbite realigns the lower teeth and jaw, which can soften the appearance of a prominent chin.
When a bite is corrected, it affects the appearance of the chin and jawline. An overbite can give the appearance of a recessed or undefined lower jaw because the jaw is positioned too far back. Moving the lower jaw forward into proper alignment using elastics can make the chin more defined and the jawline more sculpted.
For patients who have trouble closing their mouth fully due to an open bite, correction can change the look of the mouth at rest. This makes the lips appear less stretched and strained.
The Role of Tooth Extraction in Facial Alteration
In cases of severe crowding or significant protrusion, an orthodontist may recommend the extraction of permanent teeth, often premolars, to create space for alignment. This decision is the factor most likely to lead to a noticeable change in the facial profile. The space created by the extractions allows the front teeth to be moved significantly backward, or retruded.
When the front teeth are pulled back into the extraction space, the overlying lips follow their movement, resulting in a reduction of lip fullness and a flatter side profile. This retraction is beneficial for patients who start with very protrusive lips, leading to an improved and balanced profile. However, excessive retraction can lead to an undesirable flattening of the profile. Therefore, the decision to extract teeth is carefully considered based on the patient’s individual facial structure.
Age, Growth, and Treatment Timing
The patient’s age and stage of growth play a substantial role in the degree of facial change that orthodontics can achieve. In children and adolescents whose facial bones are still developing, treatment can utilize growth modification appliances, such as palatal expanders. These devices exert forces that physically guide and reshape the growth of the jawbones (maxilla and mandible). This ability to influence skeletal growth leads to the most substantial and visible facial changes in younger patients.
For adult patients, whose facial growth is complete, the changes are primarily dental and restricted to tooth movement within the alveolar bone. While adult treatment achieves significant improvements in bite and profile, it is limited in its ability to alter the underlying jaw structure. In adults with severe skeletal discrepancies, a combination of orthodontics and orthognathic (jaw) surgery may be required to achieve dramatic changes in facial shape.