Upper Front Teeth Sticking Out at 13: How Braces and Three Premolar Extractions Corrected the Overjet and Deep Bite
A real orthodontic case from our Gurgaon practice, explained for parents and teenagers.
The short answer
Upper front teeth that stick out in a teenager are usually a Class II Division 1 bite: the upper teeth sit too far ahead of the lower teeth (an increased overjet), often with a deep bite. When there is not enough room to pull the teeth back, orthodontists commonly treat it with fixed braces plus removal of selected premolars. In this 13-year-old, treatment was planned for 18–24 months and reduced the overjet, opened the deep bite and let the lips close at rest.
This case at a glance
- Patient
- A 13-year-old, identity withheld.
- Main concern
- Upper front teeth placed forward (“sticking out”).
- Diagnosis
- Class II Division 1 malocclusion, subdivision: the back teeth met normally (Class I) on one side and in a Class II position on the other, with an increased overjet and a deep bite.
- Other findings
- Lips apart at rest and gum inflammation around the front teeth.
- Treatment
- Fixed braces with removal of three premolars: upper right, upper left and lower left.
- Treatment time
- Planned at 18–24 months.
- Result
- Overjet reduced, deep bite opened, teeth aligned, and the lips now close at rest. Retainers hold the result.
In this article
What did the patient notice?
The patient came in at 13 with one complaint: the upper front teeth were placed forward and stood out when she smiled and talked. That is the most common reason teenagers and their parents ask about braces.
What a parent sees as “teeth sticking out” is usually only the visible part of a bite problem. The upper teeth can be tipped forward, the lower jaw can sit further back, the front teeth can overlap too deeply, and the lips may have to strain to close over them. Working out which of these is present is what decides the treatment.
What did we find on examination?
The clinical examination showed a consistent pattern:
- Increased overjet. Overjet is the horizontal gap between the upper and lower front teeth. Here the upper incisors were tipped forward, well ahead of the lower ones. Protruding upper teeth are more likely to chip or break in a fall or a sports injury.
- Deep bite. Overbite is how far the upper front teeth cover the lower ones. In this patient the upper teeth hid almost all of the lower front teeth. A deep bite can let the lower teeth bite into the gum behind the upper teeth.
- An uneven bite between the two sides. The back teeth met normally (Class I) on one side and in a Class II position on the other. Orthodontists call this a Class II subdivision.
- Lips apart at rest. With the front teeth pushed forward, the lips did not close comfortably without effort.
- Gum inflammation around the front teeth, which we addressed with cleaning and home-care advice before and during treatment.
The diagnosis, in plain words
Class II Division 1 subdivision: upper front teeth tipped forward, a deep bite, and a bite that is different on the left and right sides.
Why were three premolars removed and not four?
Premolars are the teeth between the canines and the molars. Removing some of them creates the space needed to pull protruding front teeth back and to level the bite. How many are removed, and from where, depends on what each side of the mouth needs.
In this case the upper right, upper left and lower left premolars were removed. The two upper extractions give room to bring the protruding upper front teeth back. The single lower extraction is on the side where the back teeth already met normally. That lets the orthodontist fit the canines together correctly on both sides and line up the centre of the teeth, without moving the other side more than necessary.
The finished bite is stable and comfortable, even though the back teeth on the two sides end in slightly different positions. This is a recognised approach for an uneven Class II bite.
Not every teenager needs extractions
Many children with protruding teeth are treated without removing any teeth. Extractions are chosen only when records show there is not enough room to correct the bite otherwise. That decision is made after photographs, models and X-rays, not at the first look.
How did the treatment work?
Treatment followed a planned sequence over an estimated 18–24 months with fixed braces.
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Records and planning
Before treatment
Photographs, study models and X-rays were used to measure the bite and plan exactly which teeth to remove and how far the front teeth needed to move.
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Premolar extractions
At the start of treatment
The upper right, upper left and lower left premolars were removed to create the space the plan needed.
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Levelling and aligning
First months
Braces were bonded to the teeth, and light, flexible wires straightened them and began opening the deep bite.
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Closing the spaces and pulling the front teeth back
Middle phase
The extraction spaces were closed by moving the front teeth back. This is what reduced the overjet and allowed the lips to relax.
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Finishing and detailing
Final months
Small adjustments fitted the canines together on both sides and lined up the centre of the upper and lower teeth.
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Removing braces and wearing retainers
After braces
Once the braces came off, retainers were fitted to hold the teeth in their new positions. This matters most for deep bites and protruding teeth, which tend to relapse without retention.
What changed after treatment?
The protruding upper front teeth were brought back, the overjet was reduced and the deep bite was opened, so the lower front teeth are now visible when she bites together. The most noticeable change for the family was in the lips: they now close naturally at rest, without strain.
Face and smile
The teeth
Clinical photographs from this case, published with written consent from the patient’s parent. The eyes are masked for privacy. The gums along the lower front teeth look red in the after photos, which is common just after braces come off and usually settles with a professional clean and good brushing. Every mouth is different; these images show one patient’s result and are not a prediction of yours.
What can braces with extraction do, and what can’t they do?
Braces with premolar extraction reliably pull protruding teeth back and correct a deep bite, but they do not change jaw size on their own, guarantee a particular face, or keep teeth straight without retainers.
What it reliably does
- Reduces an increased overjet by moving the upper front teeth back
- Opens a deep bite so the lower front teeth are visible
- Aligns crowded or irregular teeth
- Fits the canines together and lines up the centre of the teeth
- Often lets the lips close more easily at rest
What it does not do on its own
- Change the size of the jaws once growth is complete
- Guarantee a specific change in facial appearance
- Keep teeth in place without retainers
- Replace good brushing — gum health still depends on home care
- Suit every patient; many cases are treated without extractions
Is 13 the right age to fix protruding front teeth?
For most children, yes. By 12 to 14, most permanent teeth, including the canines and premolars, have come through, and the jaws are still growing. That makes it a common and effective time for fixed braces.
An earlier check-up, ideally around age seven, helps too. Some problems, such as a narrow upper jaw, are easier to correct while the child is younger. See our kids dentist in Gurgaon page for early check-ups.
Which signs are worth getting checked?
Any of the following is a good reason to book an orthodontic check:
- Upper front teeth that visibly stick out, or that have been chipped in a fall
- Lower front teeth that disappear behind the upper teeth when your child bites
- Lips that do not close comfortably at rest
- Crowded or overlapping teeth
- A bite that looks different on the left and right sides
- Biting into the gum behind the upper front teeth
None of these is an emergency. All of them are easier to plan for with an early assessment. Learn more about orthodontic treatments in Gurgaon.
Common questions from parents
What is a Class II Division 1 malocclusion?
It is a bite in which the lower teeth sit too far back relative to the upper teeth, and the upper front teeth are tipped forward. Parents usually notice it as protruding upper front teeth or ‘buck teeth’. Orthodontists measure it as an increased overjet, the horizontal gap between the upper and lower front teeth.
What does ‘subdivision’ mean in a Class II bite?
It means the bite is Class II on one side only. The back teeth on the other side meet normally, in a Class I relationship. Because the two sides are different, the treatment plan has to treat them differently too.
Is it safe to remove healthy premolars for braces?
Premolar extraction is a routine, long-established part of orthodontic treatment when there is not enough room to pull protruding teeth back or to align crowded teeth. It is decided from records and measurements, not for every patient. Many children who need braces do not need any extractions.
How long do braces take for protruding front teeth?
Cases like this one usually take about 18 to 24 months. The exact time depends on how far the teeth have to move, whether extraction spaces need to close, and how consistently appointments and elastics are kept up.
Is 13 a good age for braces?
For most children, yes. By 12 to 14 most permanent teeth, including the canines and premolars, have come through, and the jaws are still growing. That makes it a common and effective time to correct protruding teeth and a deep bite with fixed braces.
Will braces change my child’s face or lips?
Pulling protruding front teeth back often lets the lips close more easily and look less strained, as it did for this patient. How much the profile changes varies between people, and we do not promise a particular facial result. Your orthodontist can explain the likely effect from your child’s records.
Do teeth move back after braces come off?
They can, which is why retainers are essential. Deep bites and protruding teeth in particular have a known tendency to relapse if retainers are not worn as advised.
Can clear aligners fix protruding teeth instead of braces?
Some milder cases can be treated with aligners. Cases that need extractions, a large reduction in overjet and deep-bite correction are often managed more predictably with fixed braces. The right choice depends on an in-person assessment.
हिंदी में सारांश
13 साल की इस मरीज़ के ऊपर के आगे के दाँत बाहर की ओर निकले हुए थे और बाइट गहरी थी (Class II Division 1)। ब्रेसेस के साथ तीन प्रीमोलर दाँत निकाले गए, ताकि आगे के दाँतों को पीछे लाया जा सके। इलाज की योजना 18–24 महीने की थी। इलाज के बाद दाँत सीधे हुए, बाइट ठीक हुई और होंठ आराम से बंद होने लगे। नतीजे बनाए रखने के लिए रिटेनर ज़रूरी है।
About this case
This case was treated at Dr. Bhatia’s Dental Clinic. It is published so that parents can see a real sequence of treatment, from the first complaint to the finished result, rather than a promise.
Last updated:
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Medically reviewed by Dr. Sidharth Bhatia, Orthodontist, Dr. Bhatia’s Dental Clinic. This article describes one patient’s treatment and is published for general education. It is not a diagnosis and not a substitute for an in-person examination. Clinical photographs are published with written consent from the patient’s parent, with the eyes masked. Individual results vary.