Why Does My Mouth Look More Protruded During Orthodontic Treatment, and When Will It Improve?

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| This post was written directly by Seoul Bardi Dental Clinic for the purpose of providing medical information, in compliance with Article 56, Paragraph 1 of the Medical Advertising Act. The information provided is for reference only. For symptom assessment and accurate management methods, please visit a medical institution and receive guidance from a medical professional. All procedures and surgeries performed at a dental clinic may involve individual risks, such as inflammation, bleeding, and swelling. Please make your decision after having a sufficient consultation with a medical professional in advance. The treatment cases presented in this post were photographed with the consent of patients who completed treatment at our clinic, and the before-and-after photos were taken under the same conditions. |

| Directions |

Many people begin orthodontic treatment to bring protruding teeth and lips inward, only to feel stressed when their mouth appears to stick out even more during the middle of treatment.

It can be such a difficult period that they do not even want to look in the mirror.

To get straight to the point, this is usually a transitional phenomenon that occurs temporarily during the orthodontic process.

I will explain why this happens and when it usually improves.

| Chapter 1. Your mouth may look more protruded during the early to middle stages of orthodontic treatment — this is a normal process |

Sample photo

Orthodontic treatment does not move crooked teeth inward all at once.

First, all the teeth are aligned, then space is created, and finally the front teeth are moved backward into that space.

The issue arises during the first step, “alignment.”

To straighten overlapping teeth, the front teeth are often tilted slightly outward at first to secure space.

As the front teeth tilt forward, the lips may also appear to be pushed outward.

(Alignment and leveling study)

In fact, in a 3D study tracking the alignment stage, the cheek and temple areas moved inward, while the lip area became more protruded. This change appeared most rapidly during the first three months of treatment.

(PMC, 3D morphometric study)

In other words, the feeling that your mouth “looks more protruded” is not simply an illusion; it is an actual change. However, it is part of the preparation process before the stage in which the teeth are moved backward.

| Chapter 2. The bulk of the appliances and changes in the oral muscles also play a role |

Sample photo

The second reason is the appliances themselves.

When brackets and wires are attached to the front surfaces of the teeth, their thickness pushes the lips outward, making the mouth look more protruded at first.

This is often called the “duck lips” stage. In most cases, it is a visual effect that gradually subsides as the teeth become aligned.

(Total Health Dental Care)

Clear aligners are no exception.

Small protrusions called attachments may be placed on the tooth surfaces to apply the force needed to move the teeth, so they can create a similar sensation due to the thickness of the appliance.

| Chapter 3. The third factor is the muscles around the mouth. |

Sample photo

When wearing an appliance, the way you close your mouth and the muscles you use when speaking inevitably change.

Many people press their lips tightly together to hide the space left by extracted teeth. The resulting tension in muscles that were not previously used in this way may make the mouth appear more protruded.

Studies have also found significant changes in the tension of facial expression muscles, such as the orbicularis oris, during the alignment stage.

This is a neuromuscular change as the body adapts to its new environment. (PMC, sEMG study)

To summarize, the reasons your mouth may look more protruded during orthodontic treatment can be grouped into:

① The transitional stage of straightening the front teeth

② The bulk of the appliances

③ Temporary tension in the muscles around the mouth

| Chapter 3. So what will the final result be? |

Sample photo

This is probably what you are most curious about.

The conclusion is that, when orthodontic treatment is properly planned, the mouth will ultimately move inward.

When space is created through tooth extraction and the front teeth are moved backward, the lips follow, improving the side profile.

This is a consistent finding in studies treating bimaxillary protrusion through premolar extraction. (PMC, soft-tissue change study)

In one large-scale analysis, when treatment was performed according to diagnostic criteria, approximately 80–90% of patients who had all four premolars extracted experienced an improved side profile or maintained a satisfactory result.

In other words, the reason your mouth looks more protruded now is that the front teeth have temporarily been moved forward to straighten them, and the stage of moving them backward is still ahead.

< Is limited orthodontic treatment for only the front teeth possible? ↓↓↓>

In conclusion

A mouth that looks more protruded during orthodontic treatment is usually a transitional phenomenon.

It is a temporary change caused by the combination of the stage of straightening the front teeth, the bulk of the appliances, and the adaptation of the muscles around the mouth. It is addressed as treatment progresses to the stage of moving the teeth backward.

However, I understand that this can be a difficult period. Rather than worrying alone, ask your orthodontist to check where you are in the treatment process using before-and-after comparison photos and the treatment stages, rather than relying only on how it feels. That alone can greatly reduce your anxiety.

You are simply at a natural stage in the process, so there is no need to be impatient.

Thank you.

[References]

PMC — Soft tissue facial changes during alignment stage of orthodontic treatment (the lip area becomes more protruded during the early alignment stage, with the most rapid change occurring during the first three months)

J Orthod — Proclination of the front teeth during the alignment and leveling stage

PMC — Dynamic Changes in Mimic Muscle Tone During Early Orthodontic Treatment, sEMG (changes in orbicularis oris muscle tension during the alignment stage)

PMC — Orthodontic incisor retraction and soft tissue profile changes (lip retraction and improvement of the side profile after extraction and posterior movement)

AJODO — Improvement or maintenance of the side profile in 80–90% of patients who underwent extraction of all four premolars

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