Orthodontic treatment, often involving braces, is designed to align teeth and correct bite discrepancies. Because teeth are physically rooted in the jawbone, shifting their position affects the underlying skeletal and overlying soft tissues of the face. Therefore, the answer to whether braces change your face is yes, though the degree of change depends heavily on the initial dental condition and the treatment plan. Facial changes are a natural consequence of achieving functional and aesthetic alignment.
The Mechanism of Facial Restructuring
The movement of teeth is possible because of a dynamic biological process known as bone remodeling. Teeth are held within the alveolar bone, the specialized part of the jawbone surrounding the roots. When braces apply a continuous, light force to a tooth, this pressure triggers cellular activity in the alveolar bone.
On the side of the tooth root receiving compression, specialized cells called osteoclasts begin bone resorption, dissolving the bone to create space. Simultaneously, on the opposite side, osteoblasts deposit new bone tissue. This coordinated cycle of bone breakdown and formation allows the tooth to gradually move through the jawbone to its new, corrected position, impacting the facial structure.
Specific Changes to the Lower Face Profile
Orthodontic treatment significantly influences the lower third of the face, particularly the profile, by altering the underlying skeletal relationship. Correcting major bite issues, known as malocclusions, often results in a more harmonious side view.
For patients with a Class II malocclusion (overbite), the upper teeth and jaw may appear too far forward, often making the chin look recessed. Treatment aims to move the upper teeth backward, bring the lower jaw forward, or both, enhancing chin projection. This repositioning creates a straighter, less convex facial profile by bringing the lower jaw into a more balanced relationship.
Conversely, correcting a Class III malocclusion (underbite) involves reducing the prominence of the lower jaw, which can give the lower face a softer appearance. This correction typically involves moving the lower teeth backward and the upper teeth forward, minimizing the forward projection of the chin. In some complex treatments, a slight rotation of the jaw might subtly alter the overall height of the face.
Soft Tissue Adaptation and Appearance
Beyond skeletal changes, the overlying soft tissues, including the lips, cheeks, and muscles, adapt to the new positions of the teeth and jaws, altering the visible aesthetic. Lip posture, the resting position and fullness of the lips, is one of the most noticeable changes.
When severely protruding teeth are retracted, the lips may appear flatter or less strained when the mouth is closed. Conversely, aligning recessed teeth can provide better underlying support, potentially resulting in slightly fuller lips.
Some patients observe a temporary thinning of the cheeks or a slightly sunken appearance around the mid-face, sometimes called “braces face,” particularly during initial treatment. This is often related to the repositioning of teeth and the adaptation of the soft tissue to the new dental arch form. These temporary visual changes often resolve as soft tissues adapt to the new dental structure over time.
The width of the smile is also improved by expanding the dental arch, providing a fuller display of teeth. This wider, more symmetrical smile often reduces the dark spaces at the corners of the mouth, known as the buccal corridors. Correcting alignment reduces muscular strain, allowing the lips to rest in a more relaxed and natural position.
Factors Influencing the Degree of Change
The magnitude of facial change depends on several patient-specific and treatment-related variables. Age is one of the most significant factors, as younger individuals still undergoing skeletal development have the potential for more dramatic changes. Treatment in children and adolescents can guide the growth of the jawbones, allowing for greater skeletal correction and pronounced facial profile improvements.
In adults, where skeletal growth is complete, the changes are predominantly dentoalveolar, focusing on the position of the teeth within the bone, leading to more subtle facial modifications. The severity and specific type of initial malocclusion also dictate the extent of the change, with more pronounced bite issues leading to more noticeable corrections.
A major determinant is whether the treatment plan involves the extraction of teeth, typically premolars. Extractions are often performed to create space to retract severely flared teeth, which can lead to a significant retraction of the lips and a flattening of the profile. Conversely, non-extraction treatment preserves all teeth, resulting in less dramatic changes to the soft tissue profile. Treatment involving orthognathic surgery, reserved for severe skeletal imbalances, leads to the most significant alterations.