removing lower front tooth when teeth are 1/2 step forward

[dstarr]

My daughter’s orthodontist wants to remove a single lower front tooth to correct for overcrowding of her lower teeth. The two teeth behind the canines on the top have already been removed. She has a big smile, and I am concerned about the visual effect of this procedure. Her lower teeth are a perfect 1/2 step forward from her upper teeth. Can't he just move the lower teeth back a bit?

Thanks for your help

[crooked rory]

It sounds to me like your daughter has a bit of an underbite, though I do not know what you mean by a half step. My orthodontist told me that the cause of most underbites is actually the upper jaw being too far back, not the front being to far forward. If your daughter is not too old, she may be able to be treated without surgery. Once the bones are fused into place as she grows, surgery becomes the likely option. Please elaborate further, and I will tell you what I can, as a 30 year old underbite patient possibly facing jaw surgery for something similar.

Also, keep in mind that a slight underbite is not always something that needs to be fixed. My co-workers son had one, and the orthodontist told him he would not need surgery unless it caused pain or cosmetic issues. He chose not to have surgery and is doing just fine, as a college kid now. I have the same ortho that he did, though I have had jaw issues going back years now

[dstarr]

She does not have an under bite. her 4 front lower teeth are also straight, but the canines are not properly placed (overcrowding on the lower front). The issues is that she needs a bit more room on the bottom. Again, her lower back teeth are a perfect 1/2 step forward. Can they move those back a bit instead of pulling a tooth, or is there some issue with this?

Thanks,

[TMJJill]

I'm using the Damon self-ligating braces system. According to my dentist and their website, the self-ligating braces can often adjust the arch enough that teeth don't need to be pulled. It isn't for everyone, but it might be worth looking into before you have the tooth removed. I've only been in upper braces a bit over 3 months and already I've noticed a big difference in my upper arch. When it is in position, I'll get my lowers to repeat the process on the bottom.

I applaud you for doing your research before making such a big life decision for your daughter. I hope everything works out well for her.

[Labguy]

It sounds like you are concerned about this so a second opinion from another orthodontist might be in order. Removing a healthy incisor after pre-molars have already been removed? I don't know about that. What an orthodontist can and cannot do is going to have a lot to do with the specifics of the case that only another orthodontist can evaluate properly. If you trust your orthodontist, but are concerned with how it would look, you can ask for something called a diagnostic set-up--that is where a mold of your daughter's mouth is taken, the tooth "extracted", and the remaining teeth set into the ideal position so you can at least see how it is going to look. --but, again, I'd recommend a second opinion from a professional. Good luck!

[dstarr]

The premolars that were removed were on the top. No teeth have been removed from the bottom. She does not need enough space to justify removing the lower premolars, so they want to remove just the one front tooth. Again, can they just move the lower teeth back a bit since they are a bit forward anyway? I understand that since they are a perfect 1/2 step forward, her back teeth fit together nicely even though they do not fit in the normal pattern. Would a 1/2 step move make create too much space?

[Labguy]

I have no idea what you mean by "half step." But again, you really need to speak to an orthodontist because the answer to your question will depend on the specifics of your daughter's case. I don't see why they just can't move the teeth back to make room, or even expand, unless it has something to do with the bite and how the upper and lower teeth are in relation to each other. How does everything look when your daughter bites down? Are there wisdom teeth coming in? How does the extraction of the two upper teeth affect the bite? It is a question that an orthodontist can answer and not one that most on this site can. I'm sorry I can't be more help beyond recommending another opinion--but I do not like the idea of removing healthy teeth.

[ArchWired28]

dstarr

if I understand correctly, by "1/2 step forward" you mean that her lower molars are 1/2 step forward / closer to the lips compared to the uppers? If this is correct, than it is how it should be, it is called "class I occlusion". If they push her lower teeth back she will be class II and that is a big no-no. The only thing they can do is push both the uppers and lowers backwards together, but I would imagine she has no room on the top?

[purplepetunia]

My daughter’s orthodontist wants to remove a single lower front tooth to correct for overcrowding of her lower teeth. The two teeth behind the canines on the top have already been removed. She has a big smile, and I am concerned about the visual effect of this procedure. Her lower teeth are a perfect 1/2 step forward from her upper teeth. Can't he just move the lower teeth back a bit?

Thanks for your help

dstarr, kudos to you for researching this on your daughter's behalf. I had the same teeth extracted (two first premolars on top and one central incisor on bottom). I would get a second opinion from another orthodontist before having the lower front tooth pulled. You may find from the second ortho that it is indeed necessary, and that way both you and your daughter will feel better about going ahead with the extraction. If the second ortho says it's not necessary, you have the option of switching to that ortho or going back to the first ortho and discussing the possibility of trying to straighten the teeth without pulling that lower central incisor.

Good luck to you and your daughter!