Complications from biscuspid extractions? Outdated approach?

[SapphireJen]

Hi all,

I posted here about having bicuspid extractions viewtopic.php?t=16985&sid=87eee40ebb062 ... f7a3e984b3

I received the following interesting response -

you're making a BIG mistake. no question. long term, bicuspid extractions have a very negative impact on facial aesthetics and structural stability. there is more and more collaboration between orthodontists, osteopaths and chiropractors in managing the fallout from these type of extractions. by that i mean, neck pain, back pain, headaches, breathing problems and relapse over time that looks really bad. additionally, more information is pointing to the importance of having all of your teeth and good health. some orthodontists are even re-opening the gaps and putting in implants in order to resolve the chronic problems that can come from extractions!

my recommendation is to get a second, third or even fourth opinion; or until you find an ortho who can fix your problem without pulling teeth. bicuspid amputation is a very backward and out-of-date intervention!!!!!

look at the video on the damonbraces.com website that shows some of the problems from these conventional techniques.

Can you please let me know your thoughts on this. Of course - this makes me think twice about my ortho's recommendation to extract.

Thanks - Jen

[sjsarre]

I've had four extractions, my profile has changed and at first I was a little unsure about it, but now as the weeks progress I think it looks FAR better.

Like Karen said this person seems to be stirring it up a little and I would question their orthodontic experience plus the fact that they probably haven't seen your profile to judge you.

Your teeth do look fantastic, I can see the flaring issue and I do think that your mouth will look somewhat more "dainty" if thats the correct word to use. You won't have such a wide smile, but if your face is dainty and has small to medium size features then it won't be a problem.

[Rickysa]

Jen,

That quote is complete nonsense.

(Interesting first post by someone tho )

Dr. S

[Ives]

First of let me say, this forum rocks. Great advice on many things. But remember this is a public forum. Not everything you read is gospel. i would trust my Ortho PROFESSIONAL much more than a stranger on a forum.
Just my 2 cents

Ives

[storker]

ok. first of all, you have a very pretty mouth and a nice wide dental arch with full lips. this is the ideal!!! you already have what everyone wants. yeah, your front teeth are a little bucked out, whoopdy-doo. since your concern is mainly aesthetic, let me say this: the VERY, VERY HIGHEST paid and most prominent models and actresses in the world have big, horse-y mouths(gisele bundchen, karolina kurkova, cameron diaz, julia roberts, etc.). that is, they have all of their teeth. as in, no extractions. probably their wisdom teeth too. top orthos in Los Angeles (where looks=money) all do techniques like crozat, ALF, damon brackets, rpe, spreaders, etc, - anything to AVOID extractions

as for all four of your consults saying the same thing: it's called Standard of Care. it's what is taught in ortho school. so, everybody has the same education. errors and backward techniques become institutionalized.

inside your head is 80% of your entire nervous system. so, do a common sense test. yank out FOUR HEALTHY teeth, use high-force brackets and wires to close the gaps and tell me if that doesn't have the potential to cause massive stress and long-term health problems. also, it will make your arch smaller -exactly what you want to avoid. as for nonsense, orthos usually don't track their patients long-term. as in, how is the patient's health and looks 10, 15 or twenty years after treatment has ended.

everybody is probably gonna disagree on this board b/c most have either had their teeth pulled, or do it for a living. and no one wants to think they made mistake and feel bad. ok. i'm empathetic. however, considering what your mouth looks like, let me repeat: there are no superlatives to describe how dumb it would be to yank out four healthy teeth.

[platinum]

hmmm. I visit another forum, where I have read about many stories where extractions gaps had started to open....
People have been really annoyed and teeth had been bonded etc...

Interestingly, that forum is a collection of people whose ortho treatment failed. Like they wear elestics for sometime, and after the elastic treatment was stopped the teeth moved back to their original position.
I find that kind of forums interesting and informative.

[Natalie]

ok this is scaring the sesame out of me now, i had 4 extractions due to severe crowding on the bottom arch so i assume they pulled two top to even things out with my bite and what not (if they just pulled 2 bottom then i;d have a massive overjet right?)...i'm so scared now that it was a big mistake hearing all this stuff. not a lot i can do about though i guess. as great as this site is sometimes i wish i didn't read it because these sort of things freak me out. i'm just hoping that when my treatment's finished that my teeth and my face look great and i don't have any medical issues! i was under the impression that as we as a race have evolved, our jaws are generally smaller but our teeth the same size so in a lot of cases our teeth are too big for our mouths/mouths to small for our teeth. someone pls make me feel better!

[Rickysa]

everybody is probably gonna disagree on this board

While I will not speak for everyone, this is one body that does....emphatically....disagree with you.


Natalie,

Please rest assured your treatment plan is spot on.

Dr. S[/quote]

[Lisa65]

I would like to know what storker's source is for this information as he/she has not backed it up with references of any kind.

It's true that orthodontics 20 years or so ago usually consisted of ripping out healthy teeth and doing the best they could with the remaining ones. I'm a victim of 1980s orthodontia myself and it's also true that it has made things worse for me, which is why I am choosing to have treatment again now. As a teen I had crowding on my upper front teeth but my molars were in normal alignment, so if I were a teen now I would probably not need extractions. But in those days it was customary to remove bicuspids and use a removable brace to close the gaps from the front. Over time my teeth have shifted because I did not have a retainer, and my molars have shifted from a class I to a class II alignment.

There are other ways of making space in the arch now which were not generally available 20 years ago, such as molar distalization appliances, screw implants, RPE's etc etc etc but sometimes none of those will create enough room and extractions are then necessary to acheive the desired result. Everyone's teeth and jaws differ in size, and if you have big teeth and a small jaw then with the best will in the world, sometimes there just isn't enough space for all the teeth, and some need to come out.

If people's teeth move back after orthodontic treatment it is generally because they have not been using their retainers as prescribed.

if storker is a dentist or orthodontist he has not chosen to tell us so, and our resident ortho Dr S has said it's complete nonsense.

I know who I believe.

[Lisa65]

, neck pain, back pain, headaches, breathing problems

just to add - despite having had my bicuspids removed as a teenager AND all my wisdom teeth removed at age 21, I don't suffer from any of these.

[ngbraces]

SapphireJen! You have gone to 4 orthos to get consultation about your teeth. The orthos must have checked your teeth carefully. All I can say is letting your orthos know your concern, asking them all the questions until you understand clearly, then putting your trust on them. They are the ones with qualified knowledge and experience to help you make a right decision.

Natalie! Calm down! I believe your ortho had your 4 teeth extracted only to improve your teeth and bite. If you want to see how your future smile would be, look at the photos from Lynn, the board administration. She got 4 premolars pulled out during her treatment. Her smile looks more and more beautiful these days. http://www.archwired.com/photos.htm

[Natalie]

ok i'm feeling somewhat better now! thanks everyone

[Filip]

I had an upper bicuspid extracted at age 12 due to crowding. Big mistake. My upper teeth have all inclined, rotated the center toward the weaker side, including skeletal rotation of my nose towards that side (little, but noticable on close-ups).

In my opinion teeth extraction should be avoided UNLESS absolutely necessary. The basic reason is that the teeth need eachother for natural support and balance. Once you start meddling with that, it is like making adjustments of pillars, causing the teeth to seek reestablishing the neutral-force condition. That can only happen by shifting teeth to fill the gap. In my case it was by "collapsing" inwards and rotating the center.

I am no ortho, but it does make sense. Nature seeks balance. Therefore, I would seriously consider getting a 2nd, 3rd, or more opinions before extracting any healthy tooth.

I am having an implant to hopefully recreate the natural state, and brackets. I hope my nose follows

[BracesAgain]

Filip- I believe the OP is talking about having 4 bicuspids removed, which would be a symmetrical extraction technique and would not lead the problems you have described.

[Filip]

Could be, but I would be very, very, veeeeery careful about extracting anything that is naturally there. Of course, if after many (more than 2 I would hope) professional opinions the conclusion is the same, then I guess you have to put your trust in the professionals. Just make sure they are.