LAKEVILLE, SHAKOPEE AND FARMINGTON, MINNESOTA — There is a conversation that’s becoming more common among Shakopee orthodontists about the role tooth extraction plays in a person’s facial appearance.
For years, tooth extraction has been a routine part of orthodontic treatment to address crowding issues. But when technological advancements brought us palatal expanders and other appliances that helped us use a child’s growth to our advantage, it enabled us to make more room in the mouth to accommodate the teeth instead of always having to pull them.
Professionals began speculating that tooth extraction would make patients look older faster, as their skin and lips became thinner during the aging process and there were fewer teeth to support the cheeks. But this assumption isn’t true for every patient, says Dr. Trudy Bonvino, a Lakeville, Prior Lake and Farmington braces expert.
“Each patient is different and unique in his or her own way,” Dr. Bonvino says. “There are cases where tooth extraction can actually improve facial appearance and profile, and others where it lessens the amount of skeletal support.”
We take several factors into consideration when determining the best course of action. One fact that is important to keep in mind is that some aesthetic effects of orthodontics for children won’t be seen until that patient is in his/her 30s or 40s.
Let’s say a young patient has teeth that protrude to the point that he can’t comfortably close his lips. In cases such as this, tooth extraction sometimes can actually improve upon his facial appearance. Other instances where tooth extraction sometimes is the preferred approach is when correcting an underbite or an overbite.
In cases where protrusion isn’t an issue, removal of teeth can create a more sunken, older appearance once the patient reaches adulthood and loses some of the plumpness in the face and lips due to the natural aging process, says Dr. Bonvino, who also offers Invisalign treatment at Cosmopolitan Orthodontics. The upper and lower incisors act as skeletal support for the lips. Your teeth also support your cheeks. When the first premolars are removed to make more room for crowded teeth, orthodontic movements that occur can cause a shift backward in the teeth, a narrow smile, and possibly sagging or drooping.
“This shift isn’t usually noticeable during childhood,” Dr. Bonvino pediatric dentistry expert says. “Younger children have thicker skin, more collagen and fuller lips. But the natural aging process thins our skin and lips.”
That means what is done today won’t likely be noticed for decades. By that time, it is possible for the patient’s profile to make them appear much older.
It is important to remember that everyone is different, and their profiles are different. That means treatment approaches will differ among patients.
“If we can avoid removing permanent teeth during treatment to achieve an ideal smile, we will do so,” she says. “But if removing teeth will create a more pleasing profile and help us achieve a proper bite for our patient that is what we’ll recommend.”