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Do Extractions Change Faces?

Diagnoses should be based on the face and not the teeth. Orthodontists sometimes get this backwards. If I straighten teeth and don’t consider the lips, nose, chin, and soft tissue first, I could negatively affect the entire face. I must view facial skeletal asymmetries as challenges and not road blocks to success. If I discount the middle of the top teeth relative to the nose and the center of the lip, I create facial imbalance beyond esthetic repair.

Moreover, if I move teeth the fastest possible way when I prescribe extractions, I lose support for the lips, affect the nose, change the soft tissue, and most importantly, I could predispose someone to TMJ (temporomandibular joint dysfunction). 

To ensure ideal bite health and stability, I treat every extraction situation like I never want anyone to know I had teeth removed from the patient.  I never want the body to react like teeth were removed.  I want the smile to be as glamorous as someone with all their teeth present.

I use more complicated mechanics than textbook strategies.  I wait patiently for bone to remodel.  With the right amount of finesse and patient commitment, we always finish with an amazing result.

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