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Using Invisalign to reduce the facial profile

Overjet issues

Why do you get an overjet?

Sometimes teeth can move forward from thumb sucking or pen chewing and even from teeth grinding at night.

Teeth grinding or clenching is caused by the cheek muscles that press onto the teeth, pushing the side teeth in and causing the front teeth to move forward.

If left untreated, the upper teeth can continue to push forward and upwards causing the front teeth gum to shrink/recede.

Also as the upper teeth move forward, they lose contact with the lower teeth and the lower teeth may drift upwards.

Do I need teeth out?

In most cases where the overjet is 7mm or more we recommend 2 upper teeth are removed. This happens quite frequently in children and so young or old adults should not be surprised that they too may need teeth removed.

Will extractions affect my face?

Patients with a large overjet sometimes have a long narrow face and or protruding upper or both upper and lower lips.

Extraction teeth and moving the teeth back will allow the lips to be a resting angle, and also to be flatter.

If you have very thin lips then extractions may not be advised, but with full lips, extractions will help improve the facial proportions.

Will extractions affect me later in life?

Remember most teenagers have 4 premolar teeth extracted for fixed braces, and they do not have any problems later in life.

Adult extractions are quite common with orthodontics, and much safer than interdental stripping (IPR).

The lower teeth therefore prevent the upper teeth from being moved orthodontically back.

This lady had a narrow arch and the upper teeth were sticking out. She had fixed braces as a teenager, did not wear the retainers and the teeth moved forward.

The patient was not happy with her profile but did not want a quick solution, she wanted the best solution that fitted around her teeth. She felt that her upper lip stood out and her lower lip was trapped under the upper teeth.


Her lower teeth were slightly angled forwards and the lower jaw was set back. The overjet was 12mm.
This is common in patients who have a shorter lower jaw or a longer upper jaw.

The upper teeth could have been tipped back but there would only be a slight change in the profile and overjet.
We recommended Invisalign with 2 upper premolar extractions, and the patient agreed.

2 teeth were removed at the clinic and plastic fake teeth were placed inside the aligners.

The patient collected 6 aligner packets at a time and came in every 60 days for a check up.

The aligners were changed every 10 days and taken out only for eating, brushing teeth and the odd social event.

Invisalign was used as the orthodontic treatment of choice and it took 15 months to finish the treatment.

The upper teeth were reshaped at the end although the UL1 could have been reduced more.

The patient received straightened teeth and a more relaxed profile. The lower lip no longer rested underneath the front teeth, and her lips became more relaxed and in a natural position.

Jaw surgery was not needed.

In summary what looked like a surgical case ended up as an Invisalign extraction case.

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