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Paying lip service: the importance of soft tissues in orthodontics

From Volume 16, Issue 4, October 2023 | Pages 205-213


Sowmya Simon


Speciality Training Registrar in Orthodontics

Articles by Sowmya Simon

Email Sowmya Simon

Jennifer Haworth


Academic post-CCST trainee in Orthodontics, Royal United Hospitals, Bath and University of Bristol

Articles by Jennifer Haworth

Email Jennifer Haworth

Anthony Ireland

BDS, MSc, PhD(Lond), MOrth RCS, FDS RCS

Professor of Orthodontics, School of Oral and Dental Sciences, University of Bristol, Bristol, UK

Articles by Anthony Ireland


Knowledge of the facial soft tissues is paramount with regard to orthodontic diagnosis, assessment and treatment planning. This paper will describe the relevance of extra- and intra-oral assessment of soft tissues, with a particular focus on the lips, in orthodontic diagnosis, treatment planning and potential treatment effects.

CPD/Clinical relevance: Knowledge of the extra-oral and intra-oral soft tissue assessment is important in the planning and execution of orthodontic treatment.


Smiling is an innate and essential part of everyday communication. We know the position of the lips can be influenced by the underlying position of the labial segment teeth1. Similarly, the position of the lips may influence the positions of the teeth, both before and after orthodontic treatment. Therefore, there is a bidirectional relationship between the soft tissues of the lips and orthodontic outcome.

Research has shown that irregularities in the positions of the teeth can have a significant impact on smile aesthetics and, therefore, perceived attractiveness, quality of life and psychosocial wellbeing2. Orthodontic treatment may therefore result not only in changes to the position of the teeth and overlying soft tissues, but overall wellbeing.

This paper will discuss the relevance of the soft tissues, with a particular focus on the lips, in orthodontic diagnosis, treatment planning and potential treatment.

A comprehensive facial assessment includes analysis of the face and soft tissues, both in passive and animated states, with the lips being examined from the frontal and profile views. These assessments will be described in detail.

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