Effects of premolar extractions

[angeamber]

Hi all,

It's been a while. A lot happened to me in the past 2 months that I have partially had my braces on.

I'm getting my 4 premolar extractions done tomorrow and I'm freaking out despite having seen 3 different orthodontists that all said that the extraction option is the only one with the less liabilities for my case. Sigh...

I'm really scared that my face is drastically going to change (for the worst), that my upper-right impacted canine doesn't come in (despite having the confirmation that yes, it is moving)... I'm a bit of an anxious wreck.

Has anyone had this done before? What happened in your experience?

[wendydong]

I guess I don't want to scare you with the YouTube videos where a person got premolar extractions, severely unhappy with the effect on her face, reopened her extraction site, got implants, then got invisalign...

[assertives]

I didn't have an impacted canine so I can't comment on that. But I did get 8 teeth (4 premolars and 4 wisdoms) extracted before getting braces. I have definitely seen a change in my face especially since I had a very protrusive profile prior to treatment. I started out with a very round face and my face is now slimmer and my cheek area looks more chiseled which I personally do like and feel looks better especially when I contour my face with bronzer.

I think alot of people don't realize that face changes will happen even without extractions when you get braces. You are essentially moving teeth and remodelling the underlying bone, so some amount of changes will happen. As for whether the changes look good or "adverse" I think that can be subjective. Some people like a slimmer face and some people thinks a round and fuller face looks better. Personally, I HATED my round face so that slimmer face effect was something I did welcome.

Anyways, I guess what I just wanted to say was your treatment plan that was given to you by your orthodontist is tailor-made for your individual case based on your xrays, study models and photos. Your ortho would probably also has made his/her calculations on your facial profile(s) before recommending for you to get extractions based on your expected treatment outcome and after weighing the risks and benefits of the various options available. I encourage you to trust your ortho and keep an open communication with him/her. Also, do take the negative and perhaps even the postive stories on the internet with a pinch of salt because different people responds differently to the same treatment and everyone's treatment goals are different too.

[AndAndAnd]

@wendydong - Saying “I guess I don’t want to scare you...” then proceeding to do exactly that is not very helpful. The OP seems to be aware of the negatives in their post. I’ve noticed for a while that your posts are largely negative and that you appear to have had a terrible experience. However, it may be worth exercising some caution when responding to posts so that you’re not just venting your frustrations with your own treatment. Having said that, I do sincerely hope that your own situation improves.

[wendydong]

@wendydong - Saying “I guess I don’t want to scare you...” then proceeding to do exactly that is not very helpful. The OP seems to be aware of the negatives in their post. I’ve noticed for a while that your posts are largely negative and that you appear to have had a terrible experience. However, it may be worth exercising some caution when responding to posts so that you’re not just venting your frustrations with your own treatment. Having said that, I do sincerely hope that your own situation improves.

actually, i wasn't venting at all when i replied... it was mostly a sarcastically dry joke-ish way of talking.

but i also think OP should be aware of the FULL range of consequences/stories of the things that i've seen happened. I definitely wish I did..

But if i offended you or someone, I apologize. I thought all of us come here mainly because we've run into problems with our orthodontics work and we are looking for support and answers from people going through the same process.

[angeamber]

Hi all,

thanks for all your replies!

@assertives You are really right. My ortho is also very patient with me as I vocalized I was scared, he met with me to reassure me and then even let me consult a third opinion.

@wendydong Yes, I had seen so many people commenting that it changes your face for the worst. I had seen so many YouTube videos about it, but I had also seen so many people that needed extractions and didn't go forth with it and finished their treatment unsatisfied even more because they didn't comply with their plan. I think the best example I have is a YouTuber named Tatiana Gossett, which finished her treatment with an open bite and lengthened her procedure for one year because she got the extractions to close her bite. My ortho had spoken to me about palatale expansion surgery, but he felt that with an impacted canine, it's a lot to go through and very invasive. He presented the option, but it really did not seem attractive to me.

@AndAndAnd thanks for thinking of me.

I hope all your treatments are going well or are finished and can be rejoiced!

[Lovespain5]

Hi all,

It's been a while. A lot happened to me in the past 2 months that I have partially had my braces on.

I'm getting my 4 premolar extractions done tomorrow and I'm freaking out despite having seen 3 different orthodontists that all said that the extraction option is the only one with the less liabilities for my case. Sigh...

I'm really scared that my face is drastically going to change (for the worst), that my upper-right impacted canine doesn't come in (despite having the confirmation that yes, it is moving)... I'm a bit of an anxious wreck.

Has anyone had this done before? What happened in your experience?

I had my 4 first premolars extracted to correct my protrusive profile, my toothy smile and my lip incompetence. I wore my braces for nearly 3 years, I am debraced for 2 years and a half now and I am very happy with the results : a straight profile, better facial proportions, an excellent stability of the results. After 2 years and a half, only a lower incisor slightly shrifted and all the rest is still perfectly straight.

[pcspinheiro]

Yes, when you have a protrusive profile extractions are very likely to improve your profile/face in general. But when, like me, that's not the case , when your nose is already a bit large and you only miss 2mm of space for your teeth to align in the arch (leaving some overjet but nothing exaggerate), then making 15 mm of space by extracting 2 first premolars can be disastrous. I was never explained any of this, and, unfortunately, I figured it out myself too late, when 1 tooth was already gone. So I have one gap on one side and lots of anger toward my - now former - ortho because I'm way, way worse now than when I began treatment 2 years ago. Therefore, are extractions good or bad? It depends on each person's particular case, but in doubt DON'T DO IT!. It's better to prolong treatment a few more months, if later you decide you'r not happy with the non-extraction results, than to be left with a ruined face/smile, like mine will inevitably end because I will never remove another healthy tooth, EVER! However, this will most likely mean some smile asymmetry... hopefully it will be acceptable...

[Lovespain5]

To give you an idea. Photo : my before, the only case when a 4 premolar extraction is recommanded. It is called bimax protrusion.

[assertives]

I had 4 premolars extracted too to fix my protrusion. I'm not sure if I had a bimax protrusion, but I didn't have lip incompetence or weak chin. Adding my before and now photos as well to join in the fun.

[AndAndAnd]

@assertives - Great results! You must be pleased.

[Lovespain5]

I had 4 premolars extracted too to fix my protrusion. I'm not sure if I had a bimax protrusion, but I didn't have lip incompetence or weak chin. Adding my before and now photos as well to join in the fun.

Great results assertives! Your bite is perfect! How lucky to be in elastics for 4 months, I wore them for 18 months...

[angeamber]

Yes, when you have a protrusive profile extractions are very likely to improve your profile/face in general. But when, like me, that's not the case , when your nose is already a bit large and you only miss 2mm of space for your teeth to align in the arch (leaving some overjet but nothing exaggerate), then making 15 mm of space by extracting 2 first premolars can be disastrous. I was never explained any of this, and, unfortunately, I figured it out myself too late, when 1 tooth was already gone. So I have one gap on one side and lots of anger toward my - now former - ortho because I'm way, way worse now than when I began treatment 2 years ago. Therefore, are extractions good or bad? It depends on each person's particular case, but in doubt DON'T DO IT!. It's better to prolong treatment a few more months, if later you decide you'r not happy with the non-extraction results, than to be left with a ruined face/smile, like mine will inevitably end because I will never remove another healthy tooth, EVER! However, this will most likely mean some smile asymmetry... hopefully it will be acceptable...

Hi pcspineheiro, thanks for your reply! It's been a couple months since this post, so here's sort of an update on what went down. I'll start off with the biggest part: I did go forth with the extractions. However, before doing so, a lot happened. The day I was scheduled to get them removed in November at my [young and well informed] dentist. She felt that she could not go through with the procedure as airway is a SPAM topic in dentistry right now. So, I was rushed into a fourth consult with her friend, [young and well informed] SPAM orthodontist. He accepted to take a look at my case free of charge to ease my dentist's and my concerns, as we wanted to know as soon as possible if extractions was the right idea, since that was the last BIG procedure needed to be done to get my treatment underway. After 2 weeks of stress over teeth and midterms, he basically told me what ever other orthodontist had told me - needing to extract my 4 premolars to give room to my upper right impacted canine and align my top to my bottom mid-line about 5 mm to the left - so I moved forth with removing my teeth. All to say, it's been about a month already without my teeth, I look like a crazy woman and food just gets stuck everywhere, but I'll survive. I keep telling myself others must have had it worst. I am so sorry that your treatment did not go as planned. I really hope that everything will eventually be ok. Thanks to everyone else for all your messages and reassurance! May we soon be done with the metal mouth!!!