Interactions of hard tissues, soft tissues, and growth over time, and their impact on orthodontic diagnosis and treatment planning

•Good data on soft tissue maturation and aging in the perioral area are available.•Both hard and soft tissues should be considered in treatment planning.•Each patient's posttreatement soft tissue profile should be age appropriate.

The approach to orthodontic diagnosis has changed gradually but steadily over the past 2 decades. The shift away from diagnosis based entirely on hard tissue evaluations has been a result of a broadened recognition of the importance of facial and smile appearance to our patients, and how they change over time. The purpose of this article is to describe and illustrate the integration of the new soft tissue paradigm into long-term treatment planning, with a focus on the esthetic goals of treatment.