Deciduous Premolars; ortho will shave 'em down. Comments?

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#1 Post by **Neptune** » Sat May 10, 2008 4:04 am

Hey everyone!

I've been thoroughly informed by EVERYONE on this forum. I'm literally addicted to this site now (after only a few weeks), as it's helped me out so much on the road to straight teeth. Nervousness and subsequent hesitation has an amazing capacity to wear you down...

My issue is this: I have two lower premolars that were never replaced with permanent teeth. The result of this is zero overjet and zero overbite. Over time, these deciduous teeth formed cavities and are now filled. Upon visiting my orthodontist for consult, he stated that he did not want to extract the two teeth because they seemed stable enough. Instead, he wanted to shave them down so that the at least take up the space of a permanent premolar. I went along with this plan because I had no interest in having ANYTHING extracted.

But now I'm hesitating due to fear of "What if...?" The concern lies with what will I do if one or both teeth fall out at any point in this process. Implants are an option, but from perusing this forum, it seems that it's possible to extract ONLY those two deciduous lower teeth WITHOUT extracting a matching upper set. The molars would simply be brought forward. Is this a possibility? All feedback will be very much appreciated. Thanks!

Premolar references on MMB:
cersepn (viewtopic.php?t=25161)
kaycee (viewtopic.php?t=25297)

#2 Post by **ArchAngle** » Sat May 10, 2008 5:21 am

I have that also, @ over 40 on the lower jaw

1. I had an oral surgeon determine the roots have about 2 years left in them before the teeth finally fall out.

2. I am still to be braced at the bottom and we decided to bypass them (not bracket / attach them). 2 years time is when the braces come off, if and when they do fall out, implants will go in and will be positioned to match everything. Not particularly interested right now to extract them as its something like year to heal for implants plus you have to quit smoking in order to have them

Not sure what you mean about shaving them down, mine are pretty much below the surrounding teeth anyway, not even close to touching the tops. Also not clear on extraction and moving you mention.

Go to an oral surgeon, have them determine the life expectancy, not sure what other options there are other than bypassing them when being braced, when they do eventually fall out replace them with implants.

As it stands being on the bottom they don't bother in looks and they don't affect the treatment of everything else. Should they not fall out at all, I will just leave them be.

Is there something else you are having? extractions or something, the shaving down and molar moving foward just because of these two at the bottom is unclear to me.

1. have an oral surgeon determine how long they think
2. bypass them in ortho
3. if not necessary to shave them don't, (if they don't affect the treatment at all), just in case they never do fall out

#3 Post by **Luella** » Sat May 10, 2008 6:57 am

Neptune- I'm also missing my second lower bicuspids (premolars). Mine were extracted years ago in anticipation of having implants placed. However, when I got my braces off when I was around 13, they didn't want to place implants until I was about 16 (so my jaw was done growing). Between 13 and 16 I stopped wearing my retainer, and lost the spaces. (See my story- there are pictures and x rays) So here I am again getting braces so I can get the implants to replace the missing teeth. Okay, now to get to the point! I have no problem leaving them until they fall out, but I wouldn't let the ortho do any work on them- why spend money on the look of them if they aren't going to last you forever! And, if you see an oral surgeon to estimate the life span of those teeth, please keep in mind that the OS doesn't have a crystal ball and he could be dead on or dead wrong! Now, about moving the molars forward to replace them instead of keeping the spaces and putting in implants- ask the ortho or OS or whoever about the upper teeth- particularly the last ones (second molars). If an upper tooth is unopposed (no tooth on the bottom directly under it for it to chew against) it will super-erupt (grow out slowly of the upper jaw) and will eventually need to be extracted. That is why I'm going with the implants- I don't want to lose my upper second molars- I'm only 23 and I plan on doing a lot of chewing with those teeth still! I hope that explanation made sense!

And ArchAngle- You don't HAVE to quit smoking to have them placed, but it is better if you do quit. Some OS won't guarantee the implants or will edit the guarantee for a smoker, so ask about that. The Drs I work for have the same guarantee either way!

#4 Post by **Jex** » Sat May 10, 2008 7:14 am

Ooooh, Neptune, I never even thought of that! I have the same situation, but unfortunately for me, it's only on one side, so there's a big difference between the size of each premolar. I know my bite won't be ideal, but the ortho sees no reason to pull the baby tooth. I don't have my lowers yet (May 30th), but I'll be interested to see if he puts a bracket on that one. It never occurred to me that they could make the circumference smaller. (then again, mine is mostly made up of filling and would fall apart!) I don't think I'd want that done, though. I'd hate to mess with the integrity of the enamel, you know? That's just my thoughts.

#5 Post by **Neptune** » Wed May 14, 2008 12:47 pm

It turns out that the appropriate term for the procedure I'm talking about (shaving teeth) is known as IPR (Interproximal Reduction). Has anyone done this on a deciduous tooth?

#6 Post by **Luella** » Wed May 14, 2008 2:04 pm

Neptune- Looks like Gennel had IPR done today- how weird! Here's the link to her post- viewtopic.php?t=26086

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Deciduous Premolars; ortho will shave 'em down. Comments?

Deciduous Premolars; ortho will shave 'em down. Comments?

IPR on a Deciduous Tooth...Comments?