A certain amount of fullness of the lips is desirable in a child, because their
nose and chin will become more prominent as they mature. Excessive fullness
of the lips is usually caused by the teeth being too protrusive, forcing both lips
forward. If the angle between the under side of the nose and the upper lip is
less than 90 degrees, it may mean the teeth are too forward. There are
measurements that can be made on head x-rays or photos for evaluating lip
fullness, but parents’ and patient’s opinions are more important.
If they want the lips flatter, it is achievable, and if they like them the way
they are, that is important to recognize too.
If the lips are to be flattened, a common approach is to remove 4 bicuspids
(one from each quarter of the mouth) and retract the front teeth with braces.
The child can be referred to an orthodontist at any time after age 8, but generally
treatment would not begin until age 12, when the permanent teeth have grown in.
