Will all orthodontic patients develop braces-like faces? Is there a way to prevent it?

This is the 3446th article of Da Yi Xiao Hu

Almost every patient who comes to seek orthodontic treatment will ask the orthodontist a question: "Doctor, will I become a braces face?" So, what exactly is "braces face"? Will every orthodontic patient inevitably become a "braces face"?

First of all, we need to clarify a concept - there is no professional term "braces face" in all the professional orthodontic books. It is not a standardized medical term, but an objective phenomenon in orthodontic treatment. It usually manifests as depression in the cheek and temple area, making the cheekbones protrude, the fullness of the facial contour decreases, and the nasolabial folds deepen, which makes the face look old. It is usually seen in adult women who are undergoing orthodontic treatment, especially those over 30 years old.

What factors can cause “braces face”?

1. Changes in chewing habits and muscle atrophy

The masticatory muscles include the temporalis muscle, masseter muscle, lateral pterygoid muscle and medial pterygoid muscle. Among them, the temporalis muscle is located in the temple area and is the main soft tissue structure supporting this area, and the masseter muscle is located in the cheeks and mandibular angle area. During orthodontic treatment, on the one hand, due to the movement of teeth under the action of orthodontic force, the occlusal relationship is in an unstable state of constant change, and the chewing force decreases; on the other hand, most patients experience tooth pain and discomfort after periodic force application, and the chewing movement weakens, which also leads to a certain extent to a decrease in fat intake and facial fat loss during the treatment process. Therefore, the masticatory muscles do not get the same level of exercise as before orthodontic treatment and atrophy occurs. At the same time, the fat tissue loses support and sags under the action of gravity. The result of the above phenomena is that the atrophy of the temporalis muscle causes the soft tissue in the temple area to sink, and the atrophy of the masseter muscle causes the cheeks to sink. The zygomatic bone sandwiched between the temporalis muscle and the masseter muscle appears "extraordinarily prominent" against the background.

2. Age-related changes

Even for patients who have not undergone orthodontic treatment, the elasticity of the skin will decrease during the natural aging process, and the ability to restrain subcutaneous tissue and fat will decrease. The cheekbones will lose the fat padding and appear prominent. At the same time, aging also leads to a significant decrease in the thickness of facial soft tissue. This change will be more obvious after the age of 30, and the facial soft tissue of women is more sensitive to external stimuli. Orthodontic treatment often takes 2 or even 3 years. During this relatively long period of time, the patient's facial soft tissue will also undergo certain natural aging changes, which are more significant in women than in men. This is one of the reasons why female orthodontic patients are more likely to have a "braces face."

3. People who are susceptible to "braces face"

For patients who have prominent zygomatic bones, wide mandibular angles, and short and wide faces before orthodontic treatment, the facial bone structure is more prominent and they are more likely to develop "braces face" than other patients.

Is it true that every adult female orthodontic patient cannot escape the fate of "braces face"? Of course not. What are some ways to prevent or alleviate the manifestation of "braces face"?

1. Maintain normal chewing strength as much as possible. Eat tough food within the tolerable range, reduce the volume of food, and increase chewing in the back teeth area;

2. During orthodontic treatment, strengthen facial muscle training, such as grinning exercises and "braces exercises" to maintain muscle activity;

3. If the plan allows, you can choose a more comfortable correction method such as invisible braces. After taking off the braces when eating, you don’t have to worry about the brackets breaking off. The eating process is also relatively comfortable and has less impact on the masticatory muscles.

4. In the later stage of orthodontic treatment and after the end of orthodontic treatment, as the chewing function recovers, some "braces face" can improve on its own. Patients with higher requirements for facial shape can also improve through micro-plastic surgery, such as autologous fat filling, hyaluronic acid injection in the temporal or apple muscle, etc.

Finally, let’s learn the “braces exercise” together!

A. Opening and closing exercise: open your mouth as if you are yawning, and close your mouth as if you are biting an apple. Move gently and avoid using brute force to pursue speed.

B. Chewing exercise: a combination of open and closed mouth refusal;

C. Lip exercise: pouting - close your lips tightly and purse them forward, then move them up, down, left, and right;

Grin - purse your lips forward and then stretch the corners of your mouth out to the sides;

Lip rotation - purse your lips together and make a 60° circle to the left or right.

Lip spray - close your lips tightly to block the airflow and concentrate the lip force on the central third of the lips.

D. Pronunciation practice: Make the sounds of "pa pa pa pa", "da da da da", and "ka ka ka ka" quickly and lightly.

Note: The pictures are from the Internet and will be deleted if they infringe the copyright. Some of the information is quoted from Jin Zuolin's "How to Prevent "Brace Face" with Orthodontics" by Tongji University Affiliated Stomatological Hospital Orthodontics Department

Written by: Li Sijin

Reviewer: Liao Chongshan