Serial Extractions for our Children

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#1 Post by **karencoutts** » Wed Jun 24, 2009 11:13 am

Fellow archwired parents:

Many of us have crowding that is being corrected by orthodontic treatment. I am wondering whether anyone who has children with crowding has researched serial extractions.

Has anyone researched whether serial extractions are recommended? Are they harmful in any way? Should I just wait for the teeth to grow in crooked and correct them through braces? My daughter is scheduled for her second serial extraction on Saturday and I am wondering whether to cancel it. She didn't have a great experience for her first extraction (painful afterward). It was quite gruesome to see the extracted teeth, complete with roots. I am used to seeing teeth with broken roots when they fall out naturally!

I did find a study showing that there was no increase in dental fear for children who had their canines removed. Most serial extraction articles are written by dentists/orthodontists explaining the concept to their patients and are not helpful in my decision.

#2 Post by **starzz** » Wed Jun 24, 2009 2:41 pm

I had them as an adolescent. 3 sets of extractions under general anesthesia ages 11-12 removed baby canines and 1st and 2nd baby molars. Had a bottom lingual holding arch --hated that--broke it by playing with it with my tongue!! Teeth grew in pretty straight. Had braces for 2.5 years from age 14.5 mostly to correct overbite and extrude some teeth. All my teeth even baby teeth had crazy long roots and were slow to fall out -- I lost my first tooth age 7.5. It may have saved me from extracting permanent teeth. Some discomfort and self consciousness from healing /gaps but no technical problems. I would have preferred them to fall out naturally.

#3 Post by **starzz** » Wed Jun 24, 2009 10:59 pm

I wanted to add I was someone who was going through physical growth spurt early but losing baby teeth late (and my permanent teeth are very large sized).

All these extractions were performed by an oral surgeon recommended by the ortho. I realize there are always risks with "going under," but I would recommend this as a less traumatic alternative for kids if they must have the extractions.

Let's face it, losing teeth is a rite of passage for kids. By having 12 teeth surgically removed and only 8 fall out naturally, I felt I missed out. I'd say to play up the tooth fairy ritual to partially compensate.

#4 Post by **dentalguy** » Thu Jun 25, 2009 7:01 am

Hi, Karen. I'm not an expert or anything but I would be wary of extracting teeth from a growing child - unless they're something like baby teeth that won't come out. But if they are the child's second teeth surely crowding is a sign that the arches are too small for the number of teeth; not that there are too many teeth in the mouth.

Would a palate expander not help make room for those crowded teeth if the problem's in the upper arch? Also correct tongue function and breathing is apparently good for the way in which your mouth grows.

#5 Post by **bbsadmin** » Thu Jun 25, 2009 1:30 pm

When a child's face and jaw are still growing, it is NOT A GOOD IDEA to get extractions unless they are absolutely necesary and there is no other alternative. If the child's teeth are coming in crowded, it is usually better to intervene early and do palate expansion or other methods to make room.

The reason is: when you take out adult teeth in children, the jaw does not grow into the shape it would have without the extractions. The result is a flatter, less asthetically appealing face.

They still routinely extract children's adult teeth in Australia, and I understand that it is very frowned-upon by the orthodontic community.

If your orthodontist recommends extractions for your child's adult teeth, you should get at least 2 or 3 other opinons before proceeding.

#6 Post by **starzz** » Thu Jun 25, 2009 4:15 pm

I want to clarify my experience was about my extractions of baby teeth. I believe that's what the poster was asking about. I had 4 baby canines out at age 11.5, 4 baby molars out at 12 and the last 4 baby molars out at age 12.5, approximately.

I think the idea is to encourage jaw growth by making sure he permanent teeth grow in while the child's jaw is still growing. I did not have any kind of expander.

#7 Post by **karencoutts** » Thu Jun 25, 2009 10:01 pm

Thank you everyone for your input.

The pediatric dentist recommended serial extractions for my daughter. This means that the baby teeth are pulled out in a careful sequence, making room for the permanent teeth coming in. Her first extraction involved removing teeth that were already loose but very slow in coming out. The loose teeth hung around for months and months! The second incisors on the lower jaw were removed, and the third incisors were disked (shaven narrower) to make room for the permanent teeth. Only now the permanent second incisor is erupting on the lower jaw.

As for the upper jaw, the adult front teeth have already erupted and one of them is already overlapping the other front tooth. The adjacent second incisors are loose, but will likely not drop out naturally for probably months. (My guess). I had been advised much earlier to pull the second incisors, but I declined, thinking that I would see how it develops naturally first.

My husband and I both have crowding. Mine is fairly mild (you can see my Braces Stories for my pictures), and my husband's is worse, with moderate crowding and the midline off centre on the top and the upper first incisors pointing to the right slightly. Both of my daughters are showing moderate crowding even at this age. There is no space between any of their baby teeth!

So, I have sort of decided to go ahead... unless anyone who can convince me that it's somehow harmful to her arch development. The pediatric dentist said that if it was his child, he would definitely have the serial extractions done to prevent future problems with crowding. Braces are likely still in the picture, regardless.

#8 Post by **starzz** » Fri Jun 26, 2009 12:58 pm

How old is she? I think I would do the extractions it is were my child.

Interesting would not fall out even when loose! That didn't happen to me. My first and second incisors fell out on their own OK, over ages approx 7.5 - 9.5?

#9 Post by **TumbleDryLow** » Fri Jun 26, 2009 2:25 pm

All my front baby teeth were extremely slow to fall out. They would become very loose, but not want to let go completely. Had my parents ever taken me to a dentist, I probably would have had most of my baby teeth pulled by the doctor. Because my deciduous teeth did not fall out when they should have, my adult teeth came in while the baby teeth they were replacing were still in my mouth. That means the adult teeth came in behind, in front of, rotated around the baby tooth. That made for quite a mess as I did not have a wide enough arch for my adult teeth as it was. More then likely, some of my orthodontic issues were caused by retaining my baby teeth too long. If I were you, knowing what I know now, and having gone thru what I did then, I would not hesitate to pull baby teeth. When you get to correcting permanent teeth--that's a completely different story. I would never never advocate pulling adult teeth in a child.