Is orthodontic extraction necessary for chin correction? - Answer from a specialist with 18 years of experience

무턱교정, 교정발치 꼭 해야 하나요? - 18년차 전문의 답변

Doctor... because I have a recessed chin,

people say my mouth looks more protruded.

Do I have to have tooth extraction during orthodontic treatment?

In fact, among patients with a small lower jaw that sits back,

many think carefully about whether extraction is necessary while considering chin correction treatment.

When you are not only trying to make the teeth look neat, but also paying attention to the side profile of the face and lip protrusion,

it naturally makes you wonder whether orthodontic extraction is needed.

Hello.

I’m Oh Su-hwan, a dentist specializing in orthodontics with 18 years of experience.

• Department of Dentistry and Graduate School of Dentistry, Yonsei University, majoring in orthodontics
• Orthodontic specialist certified by the Ministry of Health and Welfare
• Official member of the American Association of Orthodontists (AAO)
• Official member of the World Federation of Orthodontists (WFO)

With the philosophy that patients should be given naturally beautiful smiles,

I have been treating each patient with care and sincerity.

Today, I will explain the question that patients with a recessed chin ask most often:

whether extraction is necessary during chin correction.

If you focus for just three minutes, I think you’ll be able to learn everything you’ve been wondering about.

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The key to chin correction

When people hear "recessed chin," they often think it simply means "a small chin."

In reality, however, it is often a skeletal issue that affects the overall balance and function of the face.

The biggest characteristic of people with a recessed chin is that

the chin tip sits back, so the jawline does not look clearly defined.

Because the lower jaw is positioned backward,

the distance from the neck to the chin tip can look short,

and in side profile, the chin and neck often appear almost connected.

In addition, some people experience difficulty closing the mouth naturally,

or notice that the chin tip becomes tense and uneven when the upper and lower lips are closed tightly.

Furthermore, when the lower jaw is positioned posteriorly,

the mouth can appear more protruded relative to the rest of the face,

which often leads to concerns about appearance.

Treatment period: 22.04.17 - 24.02.18 (about 1 year and 8 months)

*The before-and-after photos of the treatment were posted with the patient’s consent, and they were taken under the same environment and conditions.

So, how can a recessed chin be diagnosed?

We take a lateral cephalometric X-ray and analyze the position and angle of the jawbones.

The important measurement here is the "ANB angle."

This is an angle that shows the anteroposterior positional difference between the upper jaw and the lower jaw.

If this ANB angle is larger than normal,

→ it indicates a skeletal structure in which the upper jaw is forward and the lower jaw is positioned backward, meaning there is a high possibility of a recessed chin.

Using these objective indicators, we assess the degree of the recessed chin

and determine whether it is simply a tooth alignment issue or a problem with the position of the jawbone itself.

In cases of severe skeletal recessed chin, growth control appliances may be used during growth,

and in adults, orthognathic surgery or mandibular advancement surgery may be necessary.

However, there are also many cases that can be improved sufficiently with orthodontic treatment alone,

so it is best to receive an accurate diagnosis.

Does a recessed chin always mean extraction?

Not necessarily

Many people worry,

"If I already have a recessed chin and my teeth are moved backward too, won’t my chin look even less prominent?"

To answer first: yes, this can be controlled sufficiently in the treatment plan.

How far the teeth should be moved, which area should be extracted, or whether a non-extraction approach should be chosen

depends on the patient’s facial shape, tooth alignment, and jaw position.

There is no simple formula that says, "recessed chin = extraction should not be done."

When we make a treatment plan, we usually consider the following factors together.

<1> Anteroposterior relationship of the upper and lower front teeth (horizontal overlap, overjet)

People with a recessed chin generally have a small lower jaw positioned backward,

and the upper front teeth are often protruded.

In such cases, the gap between the upper and lower front teeth (overjet) is large,

so we may extract only the upper teeth, pull the front teeth back, and design the treatment so the lower jaw does not move further backward.

On the other hand, if the overjet is not severe, meaning the gap between the upper and lower front teeth is not large,

a plan that extracts both the upper and lower teeth to reduce overall protrusion may be chosen.

This decision is made while also considering the side profile of the entire face and the position of the chin.

<2> Degree of crowding in the teeth

If the teeth are severely overlapped or crooked, space is needed to align them evenly.

In such cases, extraction may be considered to secure space.

However, if the entire set of teeth in a patient with a recessed chin is moved too far backward,

the chin may appear even more recessed, so the amount and direction of movement are adjusted very precisely.

In other words, in chin correction treatment, extraction is not something that is always avoided, nor is it something that is always done.

The key is a customized treatment plan that comprehensively considers

tooth alignment, jaw position, lip protrusion, and the overall facial contour.

If you are considering chin correction, rather than simply worrying about "extraction or no extraction," it is best to first receive a consultation to find out what treatment is most appropriate for you.

We provide one-on-one consultations and diagnoses directly by an orthodontic specialist with 18 years of experience, so if you have concerns about your facial shape or teeth, please feel free to come in for a consultation anytime.

Thank you for reading this long post, and this has been Smile D Dental Clinic.