Why Does Orthodontic Treatment for Protruding Mouths Fail? Retruded Teeth and Protruding Mouth Orthodontics

Hello, I’m Dr. Park Yeol, an orthodontic specialist.

Today, I’ll talk about “the reasons that can ruin protruding-mouth correction.”

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Among you, many people may not have paid much attention to a protruding mouth in middle or high school, but start to become more concerned after entering college and then working.

So, what do other people think when they look at me and see that I have a protruding mouth?

As people with protruding mouths often experience, those around them may sometimes say they look unapproachable, ask whether they are angry, or say something seems to be bothering them.

The more often you go through experiences like this, the more stressed you can become. So, through this process, many people start thinking about protruding-mouth correction.

Some people get good results from protruding-mouth correction and feel satisfied, while in other cases, people end up regretting it because the result after treatment is not satisfying.

So, in what cases does protruding-mouth correction fail? The most common reason is that a retruded-teeth appearance develops after treatment.

Have you heard of retruded teeth?

A retruded-teeth condition means that after protruding-mouth correction, the front teeth are pulled back too much, making the soft tissue around the mouth look less elastic.

Also, when you close your mouth, it can look like there is less strength, and the mouth can appear smaller. If retruded-teeth symptoms that occur after protruding-mouth correction are mild, they may become much more natural over 6 months, 1 year, and then 1.5 years after the braces are removed, so they may not be a major problem.

However, if the retruded-teeth symptoms are severe, the retruded appearance and sensation can remain even 1 or 2 years after treatment, and that can become a major source of stress.

Why does this happen? When treating a protruding mouth, the upper and lower premolars are extracted and the front teeth are moved backward.

At this time, the orthodontic force should be applied somewhere between the visible part of the tooth and the root part inside the jawbone. For this to happen, an appropriate interval with orthodontic force that is not too strong needs to be applied.

However, if one tries to move the treatment too quickly, the orthodontic force ends up being applied to the tip of the tooth. When that happens, the front teeth tilt too much, and retruded-teeth symptoms occur. Does that make sense? Now, what you may be wondering is: if I have a protruding mouth and want orthodontic treatment, how much risk do I have of developing retruded teeth?

Before explaining that, let’s conveniently divide protruding mouths into three types.

The first is a case where the protruding-mouth symptom is very severe. In such cases, it is difficult to close the mouth, the person sleeps with the mouth open, and when the mouth is closed, there are wrinkles on the chin and the nose can also look lower. In these cases, you do not need to worry about retruded teeth.

If an experienced orthodontic specialist performs extraction treatment, good results can be achieved. Of course, if you receive treatment from an experienced specialist, satisfaction with the outcome may be higher.

The second is people whose protruding-mouth symptoms are not as severe as the first group, but who still have symptoms such as discomfort closing the mouth and frequently keeping the mouth open.

In cases of this moderate protruding mouth, the risk of retruded teeth is somewhat higher than in the first case. So, it becomes more necessary to receive treatment from an experienced specialist. If treatment is carried out properly, you do not need to worry about retruded teeth, but if treatment proceeds without enough attention, retruded teeth may occur.

The third case is a very mild protruding mouth, the so-called “micro protrusion.” Others may say it is hard to notice, but it is the level where the person themselves feels the protruding mouth. This includes people who hear things like, “Why are you getting orthodontic treatment? You don’t even have a protruding mouth.”

However, because they themselves feel a slight protruding-mouth sensation, they visit an orthodontic clinic hoping to bring the mouth in a little more.

When consulting such patients, many ask, “Isn’t orthodontic treatment not difficult, and wouldn’t a small amount of non-extraction treatment improve it?” Contrary to what they think, this kind of micro protrusion is not easy to treat.

What we need to be careful about is performing extraction treatment for micro protruding mouths.

That is because, in such cases, if extraction is done, the extraction space becomes too large and the mouth gets pulled back too much, which is not desirable. On the other hand, if treatment is done without extraction, we often see cases where the mouth does not move inward as much as desired after treatment, leading to lower satisfaction.

Of course, on the internet there are cases saying that for such micro protrusion, non-extraction treatment using interproximal reduction or mini-screws can produce good results, but in actual orthodontic treatment, it is not easy to achieve such good results.

Also, among people currently undergoing extraction orthodontic treatment for protruding mouths, there will be those who worry about retruded teeth. For them, I’ll share three helpful points.

First, changing orthodontic elastics too often from the early stage of treatment. If the elastics are changed too strongly and too often before 6 to 7 months have passed since treatment began, the likelihood of retruded teeth increases.

Second, if the front teeth were protruding before treatment, but their angle improves too much in the early stage before 6 to 7 months have passed. If the angle decreases a lot early on even though much of the extraction space remains, the risk of retruded teeth increases.

Lastly, if gum exposure increases in the early stage of treatment. If the amount of gum shown when smiling increases noticeably in the early stage of treatment compared with before treatment began, this also increases the likelihood of retruded teeth.

If you know these three points, you will have the advantage of being able to communicate more effectively with your doctor about the risk of retruded teeth.

That concludes today’s explanation of the causes of retruded-teeth symptoms, the main factor that can ruin protruding-mouth correction, and how to respond to them.

If you’re curious about today’s video, click below!