Lower Front Tooth Extraction for Braces

[BracedVeryLate]

wow, where were you all last year? I got one lower bottom tooth pulled because of severe lower crowding and I was absolutely fearful of making this decision. (my teeth looked similar to the ortho's website #9 posted in this thread)

Now, 11 months later, the gap is still not closed. I was told it would be about 6 months, and it's taking forever. Still about 2mm left to close.

I don't mind how the 3 teeth look on the bottom, but what I can see happening is black triangle spaces along the lower three teeth.... and, to me, it seems like my bottom arch will be much too small, and an overjet will be leftover. I need to be patient and I am driving my husband crazy.

I am trying to stay positive, but this week it's hard - i have bleeding gums and last night I had an enormous gum swelling that woke me up. my gums are not happy with the molar bands, despite my efforts to keep everything super clean.

I would love to see some photos of all of you with your three teeth on the bottom! It's more common than most people think. My two sisters both had the same tooth pulled before braces, and my ortho herself has this tooth gone also.
here's my photo:


good luck everyone, please give me some more positive news!!

[beachbum]

wow, where were you all last year? I got one lower bottom tooth pulled because of severe lower crowding and I was absolutely fearful of making this decision. (my teeth looked similar to the ortho's website #9 posted in this thread)

Now, 11 months later, the gap is still not closed. I was told it would be about 6 months, and it's taking forever. Still about 2mm left to close.

I don't mind how the 3 teeth look on the bottom, but what I can see happening is black triangle spaces along the lower three teeth.... and, to me, it seems like my bottom arch will be much too small, and an overjet will be leftover. I need to be patient and I am driving my husband crazy.

I am trying to stay positive, but this week it's hard - i have bleeding gums and last night I had an enormous gum swelling that woke me up. my gums are not happy with the molar bands, despite my efforts to keep everything super clean.

I would love to see some photos of all of you with your three teeth on the bottom! It's more common than most people think. My two sisters both had the same tooth pulled before braces, and my ortho herself has this tooth gone also.
here's my photo:


good luck everyone, please give me some more positive news!!

The part of your post that I bolded is exactly what happened to me. I will be debanded next month. Hopefully I will get pictures up.

[Susie000]

Hi there,

I had my lower left central incisor taken out 3 weeks ago.

1) The good news is that it wasn't painful, although I did feel fairly psychologically traumatised by the experience. I had it done with local anesthetic at the dentists, and although I was nervous at the time, I didn't feel a thing. My orthodontist even suggested I could go back to work afterwards, but he's obviously made of stonger stuff than me. I suppose I could have done, but a mouth full of blood stained cotton wool isn't going to impress anyone back at the office and I needed a bit of time to become accustomed to my new look.

One the anesthetic wore off later in the day I didn't feel any pain and didn't even need to take a painkiller. I just felt a bit uneasy about the gap in my mouth and limited myself to eating soup. A few days later and it was fine.

2) We're doing this in my case as there is mild overcrowding amongst my lower teeth and the orthodontist said if we took out a molar, we'd have to take out the corresponding molar from the upper jaw which would be unnecessary. I don't have any overbite, my upper and lower teeth just meet head on. If I wanted to correct this properly I'd need to have jaw surgery (I'm getting married next year - no thanks!), but by taking out the tooth we might be able to get a bit of overbite.

3) I'm in the dark as much as you are on the third question. All I can say is that 3 weeks later, the remaining teeth have started to move to fill in the gap. I can tell as there's no resistance when I use dental floss in between the surrounding teeth. The ortho reckons the gap will be gone in 3 months time.

Good luck if you decide to go ahead with it!

[magopa]

Hello! I had 4 pre-molars extracted on Monday and the process was not painful at all. I did not get a second opinion and took my orthodontist's word that I needed the extractions due to the crowding on my top and bottom arch.
To answer your last question about complications arising...watch out for dry socket. It can occur if the blood clot doesn't form over the extraction site or is washed out (ex: rinsing/spitting excessively after extraction). This happened to me a few days after my extractions and thankfully it wasn't very painful. My dentist said it usually happens with wisdom teeth extractions and not pre-molars...I guess I was just an exception.

[Susie000]

A couple of other things....

If you have a tooth out you won't have what my ortho called 'coincident centrelines'. ie, the line between your two middle front teeth won't vertically stack up with the line between your two middle lower front teeth. Unless you plan to be a tooth model, it won't matter, lots of people with 'good teeth' don't have this, and it's not noticeable.

Another thing my ortho suggested was that after my canines and incisors have been adjusted to be the same height with a brace, he'd file off any pointiness on my canines, so they'd look like incisors. The end result should be a row of neat and tidy teeth, and no one (apart from the dentist) should be able to tell what's a canine and what's an incisor.

Susan

[bopeep]

I purposely registered because of this thread. I hope I can save someone in the future that comes here. I'm in my 60's and as a child I had my lower front tooth (as well as other teeth ) extracted for orthodontia and it has ruined my arch as well as my face. I have the equivalent of a Maserati in my mouth and now I'm looking at the possibility of arch expansion. It never ends.

Never let anyone talk you into removing a perfectly healthy tooth. Every time you pull a tooth the maxillary and mandible bone erodes unless you replace it with an implant. Also you will constantly have the possibility of teeth shifting. As you age...and you will...your face needs the structure of all your teeth and a wide arch. Removing teeth narrows your arch and ages you very rapidly. People with wide arches age much better. These Ortho's that want to extract are not doing you any favors in the long run. They are giving you a quick fix. Find and Ortho that does Palate expanders. Keep your teeth!

[sirwired]

Bopeep,

Firstly, extractions of healthy teeth as part of a quality orthodontic treatment plan do not generally cause the continuous and progressive jawbone erosion issues that is virtually inevitable when unhealthy teeth are pulled for decay reasons and not replaced with implants. It is indeed a serious decision to pull a tooth and not follow it up with either an implant or braces. (But it is all some people can afford; implants are really expensive.) Because proper orthodontic treatment involves quickly filling in the extraction gaps and leaving you with a quality bite (with all the teeth at their proper angles), the jawbone does not erode, and the bite is not subject to long-term instability.

Second, 3rd-molar extractions also do not generally cause jawbone erosion problems or sunken cheeks because of the proximity to the rear of the jawbone (even when done without orthodontics); the standard of care for an impacted, but healthy, wisdom tooth that's causing problems is still simply to extract it. (It could, in theory be erupted and straightened, but this is difficult, time consuming, and not necessary for quality occlusion.)

When you were a child, extractions were indeed the standard treatment for an inadequate arch; but things have changed quite a bit over the decades, and extractions in children are now far more rare. Palatal expanders, headgear, etc. are indeed the current standard of care for children, and extractions are far less common than they used to be (but they are still needed in some cases.)

However, in adults (and this is an adult braces message board), stable arch expansion is far more difficult, and in many cases, impossible. (Even with SARPE surgery, palatal expansion in adults has a high risk of relapse.) Some fiddling can be done with the shape of the archwire to fit in teeth, but teeth cannot be moved outside the existing jawbone and be left with healthy root angles. Oftentimes extractions are simply the only choice if the patient is going to be left with a stable, quality, long-term result. An orthodontist that never extracts teeth in adults is simply not doing his/her job. An ortho that tells you that they are never needed is telling you what you want to hear.

Are all orthodontists perfect? No. Some of them do indeed pull teeth when they don't need to, and it causes problems. But others don't pull teeth when they should, and that also causes problems.

[MrsRhone]

After I get my braces put on, on Monday I will get my front tooth at the bottom removed so that one of my other tooths can have room to move into place. I was told the same thing by other orthodontists as well.

[trisportgirl]

I got my braces on November 1 (yeah, the day after Halloween was torture because I couldn't eat any candy), and I had one of my lower incisors extracted because I have severe overcrowing in my lower jaw. My bottom canines were twisted at about a 90 degree angle with my incisors, so my orthodontist said there were three options to treat the crowding:
1. Push my lower front teeth forward to make the arch larger and therefore create more space for the teeth. I have some gum recession on my front teeth, and he was worried that the extra pressure on my gums would make this worse.
2. Shave down the sides of the teeth to make them narrower so they would all fit.
3. Extract one of my incisors to create the extra space. It was his opinion that this would be the best option.

I was really worried about how it would look to have one tooth in the middle, but he said no one would even notice - I found out that this is completely true when I told my dad and he said he had the same thing done when he got braces 7 years ago! I never even noticed the difference, so I doubt anyone other than dentists will notice mine.

Over the years I have had 8 extractions (many were baby teeth, but years before they were due to come out), and 4 wisdom teeth out. The freezing is the worst part, and it's over quickly! It's just a pinch, and then once you're frozen all you can feel is pressure. If there is going to be sounds that would freak you out, they'll often give you earphones to wear too. Afterwards I have never had any pain - and you can always take advil if it gets achy.

The worst part about healing is that you have to be careful what you eat afterwards so food bits don't get stuck in the cavity where your tooth was. If you decide to get the extraction, do some reading on dry socket - I've never had this happen, but some people are more prone to it than others.

As far as my braces go, I was amazed at how quickly the gap filled! It was about halfway closed in about 5 weeks (with elastics pulling it closed), then my ortho took off the elastics and it opened up a little, but no one notices it since it's on the bottom. If you're interested in seeing photos of my progress (I take photos every week or two), just message me and I'd be happy to send them.

[Marmar]

I just received the news I need to have my lower front tooth extracted as the nerve is dead. I can get braces to close the hole. I am a little nervous as I am over 50 years old. I would like to see the photos of your progress if you still have them. Thank you.