Teeth removal before braces - Does it make sense?

PresidentMike

Hi,

I know this is a difficult question as every case is different and it needs to be examined by a specialist.

But anyway, my son needs braces and the orthodontist's treatment plan includes the removal of 4 teeth (2 at the top and 2 at the bottom). This is to allow the others to gain space and to avoid further problems when the 4 wisdom teeth come out (X-ray shows they are all there but not yet out).

I didn't like the idea of removing 4 perfectly healthy teeth! I understand this was offered to me/my son as the best option but should I ask for a 2nd opinion?? (We were waiting 6 months for this appointment!)
...or maybe I just need some comfort and reassurance that the removal of these teeth makes perfectly good sense...??

Let me also add that I didn't think his teeth were that crooked or overcrowded, and HSE turned him down because his misalignment was not over a certain number of millimeters...

Dianthus

What age is your son?
The HSE criteria for orthodontic treatment is generally only for advanced/severe cases, so just because he didn't qualify for the public system doesn't mean he doesn't need treatment at all.
Definitely seek a 2nd, or even 3rd, opinion from a specialist orthodontist for peace of mind.
No-one wants to be battling people over what the correct course of action is before active treatment has even begun .

professore

As someone who had wisdom teeth pulled, I can tell you that your mouth can feel perfectly uncrowded until those buggers come up and start giving problems.

PresidentMike

Dianthus wrote: »

What age is your son?

He is 14.

Sarac87

Hi OP,

Its not unusual for the upper and lower 4's to be removed before placement of braces. The gaps will be completely closed by the braces before the treatment is finished. I know where you are coming from they are perfectly good teeth why take them out but removing them will create space for the wisdom teeth to come through usually without too much hassel and this option is a far better one then having the wisdom teeth removed later on in life as it can be expensive. If your not happy with the treatment plan you can look for a second opinion but it is very common for premolars to be removed as part of ortho treatmemt.

btkm8unsl0w5r4

It is my limited experiance that when a patient does not have extractions prior to braces when it is needed the final result is not half as good. If there is crowding or bite issues, not doing the extractions leaves the final result not looking the best or being very unstable.

Nobody want to have teeth out, but sometimes that the egg you need to break to make the omelette. Premolars are the most common teeth to remove to make space for braces.

Just to give my experience. 3 of my kids required braces (not HSE) and out of the 3, 2 of them required teeth to be removed before putting on the braces. All were in their teens when they had it done and 2 have finished treatment.
My youngest who does not require braces, had 2 teeth removed when he was 10 as his teeth were too crowded at the time.

WardonGordon

It's all about space available vs space needed.

If you need space then you have to find a way to get it. Extractions is one way.

If you don't have enough space for the ideal outcome then you will have to accept the existing malocclusion or compromise.

Even though teeth may not look too crowded you may need space to correct other relationships between the teeth.

PresidentMike

Your comments were extremely valuable.
Thank you so much.