not sure what to do (agonizing over extractions)

[uglytoofers]

I am new to the board. I have a smaller lower jaw. But not extremely small. In terms of jaw I think my profile looks acceptable, my profile never bothered me other than my lip incompetence. Myy bottom front teeth are angled out quite a bit to compensate for the issue. So my lower lip is pushed out because of that and my top teeth sit on top of the lower lip. I also have quite a significant overjet. I have minor crowding on the bottom. Relatively straight teeth on top with a little angling out, nothing crazy. My ortho proposed two options for treatment. First is jaw surgery to move my lower jaw out while extracting two bicuspids on the bottom. And braces for 2 yrs. This will yield a better result in terms of profile. She also said I can skip surgery if my chin doesn't bother me so much and go for 4 bicuspid extractions, top and bottom with a nice final result. I had a second opinion and general consensus was the same. I can basically get away without surgery but need teeth taken out. I don't want to have a surgery and probably never will. But I am scared that pulling bicuspids will be a coverup of the problem? Has anyone had a similar issue? I am so freaked out that I am debating not doing anything at all. I also worry my tongue won;t fit in my mouth if my mouth is pushed back. Is that stupid? :( Thanks!!

[Jacob108]

Try and find someone who can provide non-extraction treatment (ie: someone who deals with functional orthodontics). Expansion in many cases is better than having perfectly healthy teeth removed to 'make room'

[TumbleDryLow]

Have you asked any of the othos if going the non-surgery route is a cover up fix? Maybe it isn't. My advice is to get multiple opinions--3 or 4 and ask that specific question. Go with the orthodontists you mesh with--one that you can talk to and who is willing to talk to you. Avoid the ones who try to dodge the question. Ask to see before and after photos of similar non-surgery cases. If you can't make a decision, don't. Sleep on it for a few years and revisit with some perspective. Once those teeth are gone they are gone. I thought about orthodontics for 10 years before doing it.

I was presented with the option of SARPE (surgery then expansion and possible need for extractions as well) or removal of 4 premolars. Although my case was very different from yours I also knew that surgery was completely out of the question for many reasons. I opted for extraction and am very happy with the results. I was warned that all my issues might not be fixed going the extraction route and I was happy to be told that upfront. I hated my teeth so much. I was 100% committed to making a change so I was OK with a compromise if necessary. I was rabid about following my orthos instructions and as a result everything was able to be corrected in the end. But as you can see from my pics, even a compromise would have been better then what I started with which is why I was ready to take that risk.
viewtopic.php?f=13&t=36436
Best wishes.

[ArchWired28]

Whatever you do, be sure to protect the health of your TMJs. Both options could harm it...
I am not sure what I would have done if I were you, maybe even nothing at all, if it does not bother me that much.
Try to find someone who is willing to go a non-extraction route first, with functional appliances for example. In adults they have limited effect but worth trying. Especially that you can have extractions further into treatment if absolutely needed. Good luck!

[uglytoofers]

Thanks for your responses, everyone. I appreciate the feedback and support. I am so lost that I am stalling and not doing anything. I am in my 30is and I really truly want it fixed. I HATE my overjet. They say I can get pretty straight teeth on top and mediocre on bottom without extractions but that won't fix my 8mm overjet. And that is my biggest beef. My teeth themselves aren't that horrible. Not great but livable. My main worry is that even right now, with my smaller lower jaw and lower teeth angled out - my tongue already rests on them when relaxed. What happens when two teeth are taken out top and bottom and things are pushed back more? I may go get one more opinion. I hate to give up on my wish to have a nice smile but I am just so freaked out to make a mistake that I am not sure what to do.

[ArchWired28]

uglytoofers

there are many people who fix overjet with braces here, I do remember most of them having extractions but not 4. If I remember correctly, one lady had only one premolar extracted on the top, the other one had nothing taken at all.
Why don't you share your concerns you've just mentioned with the orthodontist and see what he/she has to say? You have mentioned extremely good points that worse thinking over ahead of time to avoid regrets later. Seek 2nd, 3rd and 4th opinions, if needed. Try to start with someone who is willing to do non-extraction first and see how it goes. Maybe you will only need extractions on top... You never know. But I suggest you go with someone who is not fixated on the only one solution and is willing to try other was as well.
Good luck!

[secretsmile]

I had 4 extractions for braces (1st pre molars on top, 2nd pre molars on the bottom). I had overcrowding, bimaxillary protusion and an overbite. I'm too early in to see the final result but my understanding is that they're taken out in pairs for symmetry. Though everyone's different. At the time I had my extractions there was a group of us on here all getting 4 pre molars out. Here's the link to our thread: viewtopic.php?f=13&t=39269 Good luck & hope it helps...