Hesitant about extractions!!

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#1 Post by **Chapincita18** » Thu Aug 27, 2009 2:18 pm

Hello everyone! I'm new to the site and actually very glad that there is a whole board for those of us wearing braces

I just got my braces on 3 months ago and am in my late 20's. I have severe crowding in my uppers, which was most likely caused by thumb sucking when I was little. My right lateral incisor is behind my central incisor, which caused the Central tooth to be pushed out and its in the middle of my mouth, and I had an extra tooth where the lateral should have been. Not sure yet if it was a baby tooth that never came out or a permanant tooth, but it was firm and when the permanant Lateral came in, it came behind it. So there was severe crowding. My lowers are perfect though, maybe only the slightest crowding. Of course my ortho will do braces on the lowers too, but not right now.

Anyhow. I got 3 opinions before I chose the Orthodontist. First one was from my dentist who said I would have to have only the extra tooth pulled and one more on the left side. I didnt like what he had to say, so I went to an Orthodontist, who said he might have to remove two teeth on the side to make room. I didnt like that either, so I went to a 3rd guy who was recommended by a friend and he said that he could try to straighten the front teeth, but he might have to extract the two side bicuspids. I chose the third guy, thinking he would try his best to make sure I didnt need extractions.

He told me that my jaw is very small and in addition to the crowding, I have an overbite. He says now he has to remove a bicuspid on each side to create space.

I dont know...I dont know if he tried hard enough or if anything can be done. i think since I've had the braces already, I cant get another opinion. I am afraid that after the teeth are removed and its straightened, my mouth is going to look stupid, either not enought teeth or I'll look too gummy.

I think next time I will ask him if it makes a difference if I have my wisdom tooth removed. I only have one wisdom tooth on the upper, the other I got pulled because my dentist said it was decayed. But once he removed it and I asked, where the decay? He said it wasnt that decayed.

Has anyone had overcrowding and two bicuspids removed? How was the end result? Are you happy you did it?

Thanks in advance

#2 Post by **Jendz** » Thu Aug 27, 2009 7:47 pm

Hi Chapincita18,

It is very frustrating to have a dentist/ortho tell you that extractions might be necessary- not a fun thing to hear.

You might be relieved to hear a success story. I was told that for necessary alignment that my lower right central incisor, upper left first bicuspid and upper right first bicuspid would need to be removed- and it has turned out great! It took about 10 months for my gaps to start really closing, but my midline looks good and it has allowed room for my teeth to straighten nicely.

It sounds like you are doing your research which is very wise, it is so important to go into these decisions well-informed. Did you receive a proposed treatment plan from each of the three Dr.'s you visited? Perhaps once you have a proposed treatment plan you could sit down and have them explain everything. It is important that you trust your dentist/ortho and choose the one that you feel most comfortable with. I was absolutely terrified when I heard about the extractions, but I am so happy with my decision.

Please let me know if I can be of any more help!

Best of luck!

Jennifer

#3 Post by **PatJ** » Sat Aug 29, 2009 6:21 pm

I had all four bicuspids removed (as well as wisdom teeth) and it was probably the worst part of the whole orthodontic journey. Not the actual extractions, because they were straightforward and painless, but just the aesthetics of having to put up with awful gaps. However, as you can see from these photos, I had severe overcrowding and there wasn't any alternative. First photo was taken in October 2007, the second one is April 2009, 18 months later. The results have been good, and honestly I don't feel that I have suffered from the "sunken face" look. Lost a few pounds because I was eating less, which showed in my face, but don't believe this was as a result of braces. I am looking forward to getting them off in around 8-10 weeks.

Good luck!

#4 Post by **Brian1983** » Mon Aug 31, 2009 5:13 am

Hey there 26/m here and am going through the same experience with my uppers right now. The ortho that I am seeing worked some of the Philadelphia Eagles including Donovan McNabb and Terrell Owens so I didnt get second and third opinions like you so I will briefly go into my experience. I have had braces on now for 2 months and have been told that I might need one extraction to make room for some crowding. You will not know whether or not you will need extractions until your teeth are stright so the suspense builds until one day you will find out whether or not you will need the extractions. It urks me to know that I might have a huge space that might take a while to close. The ortho told me its a hell of a lot better than wearing headgear so maybe there is a little birghtside.

#5 Post by **Chapincita18** » Fri Oct 09, 2009 3:27 pm

Hi everyone! Thanks so much for your replies.

Here is an update! My ortho finally said it was time for me to get my extractions. This was a month ago. I have been in braces for 5 months and there are absolutely no change/improvement in my teeth whatsoever.

I have an appointment on monday to have my extractions. To be sure, I had gotten two second opinions from different orthodontists this week. I went to and ortho yesterday and he said that its possible to keep all the teeth and move each tooth back one at a time using pins and it requires alot of patience, but it takes a long time..so after yesterday I had my mind made up I would rather just have the extracted.

So today I had another appointment. This ortho told me that since my lower jaw was deficient (my current ortho told me this too), an option was to have surgery and pull my lower jaw out. I really dont want to do that, but he also said it was possible to straighten all my teeth but I would have a huge overbite.

Since I had my mind made up about extractions, I asked him if I should expect facial changes and he said the midline would flatten, so my upper lip would flatten. He said he did not recommend this because I was still a young lady....

Now I'm crying so hard. I dont know what to do! The last thing I want is too look older and have my face changed and not like it! My teeth can be hidden, I would rather just have messed up teeth for life than not look like myself. I love my face and think I'm beautiful. Its just my teeth I hate. I dont know what to do, I'm so upset!

I know that if you go to 10 orthodontists, you get 10 different opinions, but I'm so afraid I wont like my face after everything is done. What should I do?

The ortho today recommended I get a second opinion. I have so many already! I got two opinions before I went to my current ortho. This is the 5th opinion!

I like my current ortho and I trust him, but they dont seem to understand that the aesthetics of the face is the most important thing. When I told him I didnt want the extraction, he said that if I dont get them, my teeth wont move anymore. He even told me to get other opinions.

I wish I never even got braces. It shouldnt be this hard!

#6 Post by **starzz** » Fri Oct 09, 2009 4:56 pm

I think you should get more opinions. What I take away from your latest consult, is that ortho thinks you would get bets results from surgery. Has anyone else said that? If so maybe ask the ortho for an surgeon's referral and see what they have to say.

Nobody wants surgery but some decide it's worth the inconvenience, discomfort, risks, and costs to achieve improved bite and facial aesthetics. You could at least educate yourself about what would be involved and what kind of results could be achieved. In some cases ortho-only is a compromise treatment. Knowing all the options can help you make a decision. Good luck!

#7 Post by **khrystal1968** » Fri Oct 09, 2009 5:14 pm

Facial asthetics are important. To tell you the truth I wished I wouldn't have pulled my teeth. I should have gotten a second opinion.

#8 Post by **almost50** » Fri Oct 09, 2009 6:59 pm

First of all, don't rush into things. The decision is pretty big so do your homework and ask questions and get an opinion from an OS. It may mean a few more months in braces but be sure of your decision when you make it and don't make it because you feel you are up against a wall.

I also think you should look into the surgery route. Maybe it's because that's the route I chose for a similar situation.

I saw a total of 6 orthodontists. First one said jaw surgery. Freaked me out a bit. 2nd ortho just mentioned extractions. Didn't like that either. I have a small mouth and small teeth and the idea of removing any of my tooth presence was not appealing. 3rd and 4th gave both options but said the surgery would give me better aesthetic results.

I put it on hold for about 9 years. The last ortho I saw gave 3 options similar to you. 1. Jaw surgery to pull lower jaw forward. 2. Extractions-but said it wouldn't look good because of my narrow arch and the fact that the front teeth would have to be tilted back a little to meet properly. And it would make me look a little older. 3. Invisilign to straighten my teeth but no correction to bite and I would be left with a signficant overbite.

Once I figured out that my insurance would cover it the decision was made. I knew I didn't want to go through the entire process and feel like I settled for second best results. It is a permanent decision.

But I don't have a huge fear of surgery. And I trust my OS.

#9 Post by **Chapincita18** » Fri Oct 09, 2009 9:02 pm

In all honesty, I never liked the way my jaw looked, but I dont want to bring it out, then it will look too manly. I dont have ANY insurance, so I cant afford the surgery.

In all honestly, when I look at myself, I know that my teeth wont straighten without room created. My teeth are severely crooked. I was a thumb sucker when I was little. My lower jaw is much smaller, and the teeth are smaller. I have two teeth in the same place and no gaps! I know for a fact there is no room to straighten the teeth. How in the heck did my mouth get SO messed up!!? I know that extractions are the best route for me. If you look at my mouth, the crowding is so evident and so is the overbite. If the bicuspids are removed and the crowding is straightened out in front, there wont even be any room to move the back teeth forwards. Thats how much crowding there is.

I have been talking with my friends and they tell me not to think so much and to trust my orthodontist. I dont want to get any second opinions, I'll go crazy!

#10 Post by **khrystal1968** » Sun Oct 11, 2009 11:25 am

Funny thing with me is this. When I first got braces in Nov. 2008, I got them on in my 1st appointment. The first day I was there They had me in braces. Then fast forward 9 months and I have 3 teeth removed. Something I regret. I have a smaller lower jaw, too. No one ever mentioned jaw surgery, expansion, Damons, nothing. In fact, recently I got a hold of my records. Supposedly they wanted to take teeth out in November, but I had no knowledge of this. My side profile has not changed one bit since my teeth are gone, it is that my lower jaw looks smaller and my cheeks do not have the volume they used to. I think my ortho should have told me other options before pulling my teeth, but at the time I was rushed. I should have really thought about it. Jaw surgery? I would have gone thru it if it meant saving my teeth and my face. Now my teeth will be retracted about 7 mm into my face. I wonder what that will do to my lips?

#11 Post by **Chapincita18** » Sun Oct 11, 2009 12:54 pm

Thanks Khrystal, for sharing. I'm sorry that your experiences have been bad.

I've been carefully reviewing my face, teeth, x-rays, and the opinions of the other orthos and my ortho. I think I have made my decision. I have an appointment for tomorrow to have the teeth extracted, but I am going to cancel that appointment and instead make another appointment to see my current ortho and talk about my case. This way I can ask him all the questions floating around in my head and see what he says.

My ortho gave me options. He suggested jaw surgery and that scared me, but he looked at my jaw and said that my jaw did look ok, so if I didnt want the surgery, it was ok. He did say he would try to move the teeth and if nothing he would extract them. He did just that...it was 4 months and the sides aligned just a tad, but he know, and I know, that there are two many teeth for my mouth. I trust him. I would rather keep with him than to get all this off and try to find another ortho who knows what he is talking about and start all over again.

The thing is, yesterday I kept scrutinizing my jaw. The other ortho I got a second opinion from said my jaw was "deficient". I got home and cried so hard and looked in the mirror. I thought, "OMG, he's right! I'm deformed!" Which was news to me! My whole life I was never concerned with having a small jaw, why would I be thinking I do now?? I always thought my face was beautiful and I never had a problem getting good looking men, so why would I question my looks now at 28 years old?

So I've been extending my jaw to see how it would look if I got the surgery! I have a somewhat prominent chin already and when I extend it my jaw looks manly from the front. I dont like it! I prefer my face when its relaxed, more feminine...however my lips allign just right when I extend my jaw....my maxilary (sp?) flattens a bit, but its even...when I move my jaw back into its natural place, my upper lip goes forward..the maxillary looking more full and weirder.

I know that removing the bicuspids are the least invasive, fastest, and easiest way for my teeth to straighten. The only doubt I had was that my lips would flatten, but after extending my jaw and seeing how it looks, Its not a bad thing. I'm just worried about the loose skin around my mouth, will it droop and make me look 60?

Anyhow....even though I think I made up my mind, I'm still holding off on the extractions untill i talk to my ortho about my concerns. Hopefully he will make me feel alot better.

Oh, and by the way....I've been scouring the internet in search of before and after pictures from extractions but I cannot find a thing! I just want to see how the lip line/midline looks. Can someone help me? Thanks!

#12 Post by **Chapincita18** » Sun Oct 11, 2009 12:54 pm

Thanks Khrystal, for sharing. I'm sorry that your experiences have been bad.

I've been carefully reviewing my face, teeth, x-rays, and the opinions of the other orthos and my ortho. I think I have made my decision. I have an appointment for tomorrow to have the teeth extracted, but I am going to cancel that appointment and instead make another appointment to see my current ortho and talk about my case. This way I can ask him all the questions floating around in my head and see what he says.

My ortho gave me options. He suggested jaw surgery and that scared me, but he looked at my jaw and said that my jaw did look ok, so if I didnt want the surgery, it was ok. He did say he would try to move the teeth and if nothing he would extract them. He did just that...it was 4 months and the sides aligned just a tad, but he know, and I know, that there are two many teeth for my mouth. I trust him. I would rather keep with him than to get all this off and try to find another ortho who knows what he is talking about and start all over again.

The thing is, yesterday I kept scrutinizing my jaw. The other ortho I got a second opinion from said my jaw was "deficient". I got home and cried so hard and looked in the mirror. I thought, "OMG, he's right! I'm deformed!" Which was news to me! My whole life I was never concerned with having a small jaw, why would I be thinking I do now?? I always thought my face was beautiful and I never had a problem getting good looking men, so why would I question my looks now at 28 years old?

So I've been extending my jaw to see how it would look if I got the surgery! I have a somewhat prominent chin already and when I extend it my jaw looks manly from the front. I dont like it! I prefer my face when its relaxed, more feminine...however my lips allign just right when I extend my jaw....my maxilary (sp?) flattens a bit, but its even...when I move my jaw back into its natural place, my upper lip goes forward..the maxillary looking more full and weirder.

I know that removing the bicuspids are the least invasive, fastest, and easiest way for my teeth to straighten. The only doubt I had was that my lips would flatten, but after extending my jaw and seeing how it looks, Its not a bad thing. I'm just worried about the loose skin around my mouth, will it droop and make me look 60?

Anyhow....even though I think I made up my mind, I'm still holding off on the extractions untill i talk to my ortho about my concerns. Hopefully he will make me feel alot better.

Oh, and by the way....I've been scouring the internet in search of before and after pictures from extractions but I cannot find a thing! I just want to see how the lip line/midline looks. Can someone help me? Thanks!

#13 Post by **Chapincita18** » Sun Oct 11, 2009 12:57 pm

(I cant figure out how to edit posts)

Also, another thing. When I critique my face, I find by extending my jaw back and forth you can really get a feel for how your teeth will turn out once the extractions are done and everything is lined up. When I relax my jaw I cannot BELIEVE how excessive my overbit is!! And the crowding to boot? Wow, my ortho is very right.

#14 Post by **Takako** » Mon Oct 12, 2009 7:58 pm

I had extractions and haven't noticed a change in my face at all... I had four teeth removed, all four first premolars. However, I had a thin face to beginwith without a lot of soft tissue. The only place I think has gotten thinner - and it may just be more hopeful wishes - is the outside of my upper lip. The space outlined by the "smile" wrinkles drawn down from your nose. I played a brass instrument for years and had very strong mouth muscles, but I personally felt this area of my mouth looks puffy; it even projected outwards if you took a photo from the right angle, instead of being a smooth line from my nose down to my lips. And it's just the two areas near the corners of my upper lip. Now it's a LOT better, but that could just be me lol. I think when the brackets come of it'll look even better.

You're very right about relaxing your jaw and bringing it forward, that's a very good indicator of where your jaw will rest when you're through. And doesn't it just feel better too? I can't wait for elastics or whatever comes next so we can extract my back teeth or do whatever needs done to get my jaw to sit in a proper position.

#15 Post by **gracey82** » Mon Oct 12, 2009 8:23 pm

If you look at my stories and pic, you could tell its not serious case to begin with. Yes to the orthon i have abit of crossbite. but that does not affect my smile. I love my smile but I just find my front teeth a little bit protuding and thats y i got braces. 3 orthon said I need extraction, which I know in my case does not because I dont have much crowding. I eventually stick with the orthon who is concerned enough about my worries and adopt non extraction approach. Probably stripping of the teeth for little space.

Talk to you orthon. Tell them you dont like narrower smile with fewer teeth. I like broad smile with full teeth shown. Most of the beautiful HOllywood smile are full broad smile, and not a narrow one.

Ask if you can do filing of teeth and expansion to expand the jaw. Orthon always go for extraction because its the easiest way out for them to aligned your teeth, thats wat they concerned about!