In the 2nd series on tooth removal, let’s take a look at the main reasons when tooth removal is the best and wisest option to achieve an optimal treatment outcome.
Reason #1 Crowding.
Imagine a situation where teeth are crowded and poorly aligned. In this situation, the amount of space required is not sufficient to accommodate the teeth. Either the size of the arches must be increased or the number (or size) of teeth reduced. Or perhaps space preservation with a space maintainer could be utilized.
Up until the age of about 15, if there is mild to moderate crowding, it can be addressed with expanders and braces alone. After the age of 15, the bone structure is well formed and less plastic and expansion may not be possible or healthy to the surrounding supportive tissues.
When there is moderate to severe crowding and limited gum or bone support, permanent teeth will need to be removed to provide the space required. Failure to maintain the teeth with healthy surrounding bone will lead to periodontal problems down the road.
Reason #2: Protrusion or forward positioning of the teeth and upper lip.
The underlying teeth determine the posture of the lips. If the front teeth are already forward, than lip posture and facial appearance may be improved by removing some on the sides. Then the upper teeth can be moved backwards. When the top front teeth are crooked but the lips are in good position, removing teeth may be critical to prevent the teeth and lips from sticking out.
Reason #3: Correction of an overbite or underbite.
Imbalances may exist between the upper and lower jaws and surgical correction may be the only method of correcting these problems. However, if the discrepancy is not so great, it may be possible to mask or hide the underlying jaw imbalance by shifting the teeth into a better position. If the patient’s treatment desires can be achieved with a more limited approach, it would certainly be preferable to avoid surgery. On these occasions extraction of upper or lower premolars may be the solution.
There are many other compelling reasons to elicit a recommendation for tooth removal as part of your treatment. These include asymmetries, missing, impacted, or extra teeth to name a few.So, in the situations just described think of extractions as sometimes being a healthy and safer approach to care.
I have seen too many instances of adult patients who had received previous non-extraction orthodontic treatment who would probably have benefited from extraction. The consequences of non-extraction may have a profoundly unhealthy impact on periodontal bone health. There is a time and place for extraction and that is why a very well designed and reasoned orthodontic treatment plan is so important in terms of achieving the desired treatment outcomes.
In our practice we use the power of SureSmile digital treatment planning software to perform virtual treatment. That means we can plan your best treatment options on the computer screen by simulating different tooth movement strategies. It’s the equivalent of testing different medicines in the lab before using in real world applications. This is the essence of true personalized orthodontics, the safest and healthiest approach to patient care. As always, at the consultation appointment we provide our patients with an extremely detailed and comprehensive analysis of their treatment needs based on our clinical findings and the ideal strategy to address those needs. Educated patients are the best patients!
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When you are looking for an orthodontist, you want to search for an experienced professional who is board certified, attended the best specialty training program, and is active in their professional organizations and communities. When you meet Dr. Mark Feinberg, you’ll find he is exactly that. He brings that knowledge and experience to his patients, young and old, providing exceptional orthodontic care. Feel free to call us if you have any questions about the information we have shared or if you would benefit from orthodontic care at 203-892-6822. Dr Feinberg will examine your teeth and get you started on the best treatment plan for creating a lasting shining smile.
If you have any questions about early treatment, don’t hesitate to contact our office, Mark Feinberg Orthodontics. Also please feel free to request a copy of our resource guide on early orthodontic care.