RedCatWaves

My daughter had an orthodontia consult today. She is missing one of her permanent bicuspids on the bottom...it just isn't there...and, since she has a lot of crowding in her mouth, the ortho is proposing that we remove the 3 corresponding teeth to relieve the crowding as part of the braces treatment. I'm very apprehensive about pulling 3 perfectly good teeth. Anyone have this done?

I had overcrowding as a kid too, but my ortho used a palate expander to make more room. This ortho doesn't seem to think her palate is too small. I dunno...pulling teeth is just not sitting right with me...but he's supposed to be one of the best orthos in the area. If we don't pull, I assume we'd have to somehow replace that missing tooth.

gekko422

When I was a kid, I had 4 premolars pulled for braces. The nice thing about it was that now my wisdom teeth fit and I have no problems with them.

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TRBL

She is missing one tooth, so he wants to pull THREE more? That makes no sense to me at all.

Disclaimer: I am not a dentist, I do not play a dentist on TV, I do not currently wear braces, and I have not in the past at anytime worn braces. So basically I know nothing, other than it sounds weird.

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poisonivy

I had 4 teeth pulled as a kid but that was back in the dark ages. Now my oldest and 2 others have had a small palate and no teeth have been removed. DS & DD had a palate expander put on when they were 3. Ortho said expand the palate and their cross bites would correct themselves. They will have to wear a retaining wire until we decide if they need braces or not around 12. My oldest DS had an expander twice before he got his braces. No teeth ever removed and his teeth are beautiful. You could always get a second opinion if your not sure.

redheadfullofcurls

I would get a second opinion.. I work for an dentist that does FASTBRACES and he doesn't extract teeth for ortho.

Is there a space where the tooth never came in or are the adjacent teeth closed to together?

I could see maybe extracting the other premolar on the opposite side to make her teeth symmetrical.. but 3? Weird.

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frau

my daughter had 4 teeth removed (2 top, 2 bottom)
see for yourself if you think it was worth it from her orthodontist's webpage:

(her teeth are no longer pictured so i removed the link)

my fotki:
face and teeth

more recent face and teeth

NetG

My brother was missing a tooth and had a tooth pulled for symmetry.

Then they put a fake tooth in between his front bottom teeth.

STUPID.

I can't see why pulling three teeth would be necessary, instead of just one. I'd definitely get a second opinion, because as a layperson it sounds ridiculous, but may have to do with how it will affect her bite.

I had a palate extender, too. Several of my remaining baby teeth were pulled prior to braces, and the palate extender allowed the permanent teeth which were too crammed to come down to do so within the first six months I had braces.

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frau

fyi, none of my daughter's teeth are fake.
she had severe overcrowding.
you don't replace the missing tooth, the other crowded teeth move in it's place.
if you look at the video of her teeth you'll see that she had 4 teeth behind each upper canine. they removed one from each side. you can count that only 3 remain behind the canine after the teeth are straight. do you miss it? no. you don't even know it was ever there.
the same story for the bottom teeth. he pulled one from each side. it doesn't make a visible difference.

mad scientist

I had something similar. One of my back molars was impacted (tipped on its side) due to overcrowding, and the dentist suggested we pull all 4 out to make room for the wisdom teeth. That's what we did. i now have my 4 wisdom teeth and they've never been a problem.

I never needed braces, but I'm sure pulling out these teeth allowed the rest of my teeth to spread out a little bit.

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mrspoppers

I'd get a second opinion. It can't hurt and it might just reinforce the treatment plan the first ortho suggested. When I had my braces a couple years ago, both my orthodontist and dentist said that they don't pull teeth these days like they used to. They try to move the teeth in other ways if they can because teeth need to be tight in order to prevent shifting later. I ended up having one tooth pulled in the front bottom, but it was over a year after getting braces.

It's possible your daughter's mouth really is to small for all those teeth. A palate expander can only do so much. However, I'd want to make sure pulling teeth is the right thing to do before it's actually done.

RedCatWaves

Oh, thanks Frau. She has a beautiful smile now. That gives me hope, because my daughter's teeth are similar to your daughter's before picture, although probably a little more crowded. I can only hope for a similar outcome.

I think I still might get a second opinion. Ortho consults are free...might as well get a third one too.

caribcurls

This. I didn't have severe overcrowding, but I had a fairly large overbite.

It's really not that big a deal. Just make sure that she wears her rubber bands religiously to close the gaps. Once the gaps are closed you can't even tell. It's also much easier upkeep as the expander can be a pain to clean and to turn the key (my nephew just recently got his expander removed).

How old is your daughter? I ask because some doctors don't like using an expander once the palate bones are fused.

RedCatWaves

There is a little bit of space where the tooth should be, not much though. The missing tooth is on the bottom, but the top is where she especially has overcrowding, so I guess that's why he's suggesting removing all 3 corresponding premolars.

RedCatWaves

She's 13. I had a palate expander at 14 and my palate opened right up. I remember it well. It can be used up til age 15 or 16, I think, possibly even beyond.

caribcurls

Hmm, so its not age. Maybe it deals more with her bite. If they remove the corresponding bottom tooth to make her bottom teeth symmetrical, then her top teeth and bottom won't match, affecting her bite (which I think could be problematic).

Either way, if it makes you feel more comfortable, get a second opinion, maybe even a third. That way, whatever decision you make you can be comfortable with.

curlyarca

Frau, your daughter's before and after is a great advertisement. Based on that, I'd go with the ortho's recommendations.

I had all of my wisdom teeth extracted. I wish he'd only extracted 3 though. My right upper back teeth are way more spacey than I'd like them to be. Of course, only I notice this, but still.

I've never had or needed braces. Sucked my thumb all through lower elementary, too. Still perfectly straight teeth. I'm really impressed by how much of a difference orthodontia makes.

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SCG

I had horrible teeth for a long time - they were really crowded, with a terrible overbite. In fact, everyone on my mom's side of the family has the same overcrowded bottom teeth... But, mine were crowded on top, too.
My orthodontist (who actually specialized in orthopedic orthodontia/dentofacial orthopedics) said he could technically pull teeth, but he thought I'd have better luck with appliances and a more "gentle" form of moving the teeth.
I had expanders for the top and bottom, numerous rounds of spacers, braces on and off, more appliances, etc. It sounds like a hassle, but honestly I much preferred it to having teeth removed. Now, I almost have too much room on the bottom, and he had to put in a tiny permanent retainer behind my bottom teeth to keep them from moving too far apart. And, personally, I think my teeth turned out nice.

But yeah, like everyone else said, I'd check into getting a second opinion.

ETA: And, I should mention, that I have a small mouth. Big smile, small mouth. Haha

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M2LR

When I was younger, I had baby teeth pulled due to over crowding, my parents couldn't afford braces, so they pulled baby teeth, and one permanent tooth. My front teeth look great, but my bite in the back is off. I was around 10 or so when they pulled the permanent tooth, probably 8 or 9 when they did a couple of baby teeth.
My son saw the ortho on Tuesday, and the doctor said that he only pulls permanent teeth as a very last resort after doing the expander and a retainer. My son is 8 though, so I am not sure if age makes a difference, maybe she's too old for the expander?

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Wiregirl

Yes that's sounds right if she has major crowding. Some people just don't have room in their mouth for all the teeth. I had 4 removed for my ortho at age 21. (I worked for the orthodontist at the time). SO it sounds right to me!

wavyblonde

I had 4 permanent teeth pulled for braces, and my teeth turned out great. I have a small mouth, and it made sense to make more space in there, I guess. When I think about it now, I think the concept of pulling viable teeth is kind of weird, BUT...my sister, who has a much larger mouth and kept all her teeth, has to still wear a retainer lo these many years later, and I don't. In fact, I barely had to wear my retainer. My teeth just stayed put.

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