This comes down to the treatment plan, because in some cases we may see very mild crowding. That means that the teeth are not very overlapped, they are pretty straight. All you need to do is straighten them up and the case will look nice. But for a lot of our Asian population, it’s very normal to have protruding lips. So that means that from the side view, they come out, and they do stick out quite a bit. For some people, it’s a concern. If it is then you may need something more drastic to create space so we can push the teeth back and the lips will follow, which would usually be extractions. But some patients don’t really care about their lips, or maybe they like the more prominent lip look. I mean, nowadays lip fillers are very popular, like people are trying to get their lips poutier, so it’s very personal.
In that case, it again comes down to the treatment plan. Sometimes I would present two different plans, and I will tell the patient that if we do this we can get the teeth straight without extractions but the side effect is that the teeth may protrude forward and the lips may stay the same or go out a little bit, is that okay with you? Then we go back and forth, and try to find something that the patient is happy with. You don’t want to do the treatment and then you find out at the end -- it’s a very embarrassing moment because we know it’s going to happen but sometimes the patient might not realise that this is not actually the result that they desire.
