Hi,
Im 23 and have been thinking about braces for a while. but i've finally come close to actually getting around to going through with it.
ive been for the initial consult and the impressions and im due to go back next week for the final consult and treatment plan
The problem: my teeth are slightly crowded, front teeth overlap slightly, arches are a bit narrow, overjet about 2-3mm on left side and 4-5 on the other, i guess ill know exactly what the problems are when i go back next week.
anyway to complicate things, im missing a 1st molar from the top left and bottom right. however the second molar sort of took its place and my wisdom tooth came down aswell. ortho planned on keeping the wisdom tooth.
so ortho wants to extract one tooth on top right to make space. probably the first premolar on right, but wasn't completely sure until after the xrays etc.ordinarily they make symmetrical extractions, but as im already missing a tooth from the left he wouldnt want me to lose any others.
so has anyone had this done? just the single premolar extraction from the top. what did the outcome look like? im concerned that cos its not symmetrical it might look strange.
also, would this cause other problems with bite, midlines, stability etc
would they ever extract a first molar? would it be possible to extract the first molar and bring the second molar forward and let wisdom tooth come down. this would be symmetrical but i doubt it would be a likely approach. anyone heard of this being done?
any advice would be great, or questions or concerns i should raise with the ortho re the single extraction. i figure the more information i go in with the more likely ill have some proper questions to ask. couldnt really think of much to ask at the initial consult. although this was probably cos i was a bit nervous.
apologies if my post is long and confusing, i guess a photo might have explained it better.
also,
1. should the ortho be able to give u a reasonable idea of what the final outcome they are aiming for should look like. ie what would be ideal and what is actually achievable given your situation?
2. at the outset advise of any additional appliances they intend using. think id rather know in advance than be surprised.
3. ortho mentioned one of my upper lateral incisors being a slighly strange shape. is bonding and reshaping common, and is it usually the ortho who does or would it be your dentist?
4. anything else i should clarify with the ortho at my final consult?
any advise would be very much appreciated.
thanks,
Elle
single upper 1st premolar extraction?/missing top 1st molar
Moderator: bbsadmin
Your treatment proposal sounds like its good for your situation.
I just started my treatment a couple of months ago and have had just one upper premolar out on the left side. Before I agreed to the treatment I was worried as it didn't sound right at all. In the end I booked an extra consultation to discuss it with the ortho and asked to see photos of other patients who had asymetrical extractions like this. He said my midline is off in relation to my face as it was and so all the front teeth need to shift to the left anyway to correct the midline. I made him show me this in the mirror and I did see what he meant in the end.
He plans to carry out tooth reduction on the right side so all the space is not going to be created from the left premolar extraction. As you already have that missing molar on the other side, you probably don't have much to worry about in terms of symmetry. Best to preserve a molar as it gives more support in the arch than a premolar, so I guess thats why they want to remove the premolar rather than the molar. And its less space to close up.
Maybe you should give him a call before your consultation to let him know you want to see some photos. When I asked he couldn't remember the patients' names at the top of his head and needed a bit of time to dig out the relevant photos. But don't be afraid of writing all your questions down and taking them to your consultation next week. I had to do this I would have never remembered them all otherwise.
Going on my own experiences I would almost certainly say that for any bonding then your normal dentist would do that as it involves more general dentistry skills than the ortho uses normally. For any reshaping related to reducing tooth structure then the ortho will do that.
I just started my treatment a couple of months ago and have had just one upper premolar out on the left side. Before I agreed to the treatment I was worried as it didn't sound right at all. In the end I booked an extra consultation to discuss it with the ortho and asked to see photos of other patients who had asymetrical extractions like this. He said my midline is off in relation to my face as it was and so all the front teeth need to shift to the left anyway to correct the midline. I made him show me this in the mirror and I did see what he meant in the end.
He plans to carry out tooth reduction on the right side so all the space is not going to be created from the left premolar extraction. As you already have that missing molar on the other side, you probably don't have much to worry about in terms of symmetry. Best to preserve a molar as it gives more support in the arch than a premolar, so I guess thats why they want to remove the premolar rather than the molar. And its less space to close up.
Maybe you should give him a call before your consultation to let him know you want to see some photos. When I asked he couldn't remember the patients' names at the top of his head and needed a bit of time to dig out the relevant photos. But don't be afraid of writing all your questions down and taking them to your consultation next week. I had to do this I would have never remembered them all otherwise.
Going on my own experiences I would almost certainly say that for any bonding then your normal dentist would do that as it involves more general dentistry skills than the ortho uses normally. For any reshaping related to reducing tooth structure then the ortho will do that.
Let your ortho know that the thought of having an asymmetrical extraction bothers you. If it continues to bother you and your ortho won't change the extraction or you don't like his explanation of why he's doing this, you can take your records to another ortho for treatment.
My ortho wanted to extract the 1st premolar on the bottom right and the 2nd premolar on the bottom left. This bothered me because my 2nd premolars on the bottom are both broken (the top part of them broke off when I was 15, while I was eating Cheez-Its
), so they look shorter than the 1st premolars. It's more obvious on the left one than on the right one.
I explained to my ortho that I wanted the 2nd right premolar extracted instead of the first and he agreed to have the oral surgeon do that.
As far as additional appliances, he told me at my 2nd consult, after my records were done, that I would wear a transpalatal arch for a while.
My ortho wanted to extract the 1st premolar on the bottom right and the 2nd premolar on the bottom left. This bothered me because my 2nd premolars on the bottom are both broken (the top part of them broke off when I was 15, while I was eating Cheez-Its
), so they look shorter than the 1st premolars. It's more obvious on the left one than on the right one.I explained to my ortho that I wanted the 2nd right premolar extracted instead of the first and he agreed to have the oral surgeon do that.
As far as additional appliances, he told me at my 2nd consult, after my records were done, that I would wear a transpalatal arch for a while.