Metal Mouth Message Board

I am 15 years old and recently had 4 pre molars extracted, due to severe over-crowding, and a slight under bite / over jet. I am wondering how noticeable the facial changes will be after braces. Thanks!

I have read of this happening, but I've also read of extractions not having undesirable effects to the facial structure. There's an abundance of literature on the internet about this topic, but obviously nothing should replace asking your ortho for some upfront and frank answers to your concerns.

I hope you find the answer you are looking for to ease your worries.

Good luck on your journey!

The vast majority of extraction cases turn out just fine. If you search around here, you'll find a thread where people have posted pictures of famous actors/actresses/other celebrities that are by all accounts rather attractive and have had extractions. (It's obvious if you know what to look for.)

Speaking personally, my wife had four extractions as a child, and she has a gorgeous smile.

sirwired wrote:The vast majority of extraction cases turn out just fine. If you search around here, you'll find a thread where people have posted pictures of famous actors/actresses/other celebrities that are by all accounts rather attractive and have had extractions. (It's obvious if you know what to look for.)

Speaking personally, my wife had four extractions as a child, and she has a gorgeous smile.

Glad you weighed in on the subject, sir!

Similar to another reply I made earlier, the key is that extractions do not ruin the face. There are definitely places for extractions still in orthodontics despite the "new wires" and "new braces". The key is the proper diagnosis and then the execution of the treatment plan to properly close the space, since the space can be closed moving front teeth back, back teeth forward, or a combination of both. In other words, extractions do not ruin the face, but improper extractions and improper mechanics by the doctor and their team will produce different results.

I've been really worried about this as well as I am due to have 4 premolars out for severe crowding. There is so much on the Internet stating that it will ruin the face, cause TMJ, breathing problems etc. Rationally I know this is not true (there is no way this happens to everyone!), but it certainly can scare you! I can understand how it can have a negative effect when people don't need them, but for some people the space is needed. I have 32 teeth and a small mouth, so I think it makes sense for me.

I had 4 of my pre molars removed. I do not see any facial changes. Some people said I look a "little" different but not significant to the point that you'll hate yourself. You should be fine.

Signed up to this message board just to respond to this. I'm pretty shocked at all the people still saying extractions won't ruin your face. It's a little infuriating. Yeah, maybe if you're already a very attractive person or younger than 30 you won't notice too much, but when you shove teeth back, you're shoving the maxilla back and that definitely leads to a flatter profile, thinner upper lip, premature aging, collapsed airway, TMJ etc. I know because it happened to me, and my orthodontist was considered top notch.
It can cost $20,000 to reopen the extraction points and have implants put in. The effect on one's face and one's mental state is impossible to put into words. The fact that it's even legal to pull healthy teeth, especially in minors, is ridiculous. NEVER remove heathy teeth if you want to "age gracefully", in every sense of the term. It's an outdated practice that leads to lifelong health problems. The only reason to extract teeth is it makes the orthodontist's job easier and less time consuming. A pallet expander can encourage forward growth in the skull and help align teeth for people in their 20s, 30s, 40s and later. I'm surprised if you've read up on the internet about this you've even need to come here You want straight teeth but you're going to want an attractive facial structure that will actually hold your skin up even more.

Also, my partner also would say I'm attractive with a nice smile. Most people are pretty biased when it comes to evaluating the looks of people they know, but the pictures don't lie. They've done studies on twins several times, where one gets extractions and the other gets a pallet expander. Each time the twin whose had extractions for braces looks so much worse they don't even look identical anymore. If you've searched the internet you must've seen these??

Can't you pull the remaining teeth forward versus backwards? I imagine that would help one's profile. Also, I will be getting extractions in December as part of my treatment and my ortho has assured me that he has taken any possible facial changes into consideration. Due to the angle of my teeth and the crowdedness of my teeth he does not believe that the extractions will cause any noticable change in my appearance. While I am sorry that you did not have a good experience with extractions it is not fair to suggest that most people will have a similar experience. Some people simply do not have enough room in their mouth to fit all of their teeth. If you straighten teeth without extractions when they are needed you run the risk of recessed gums and flared teeth after treatment.

cmigg wrote:Signed up to this message board just to respond to this. I'm pretty shocked at all the people still saying extractions won't ruin your face. It's a little infuriating. Yeah, maybe if you're already a very attractive person or younger than 30 you won't notice too much, but when you shove teeth back, you're shoving the maxilla back and that definitely leads to a flatter profile, thinner upper lip, premature aging, collapsed airway, TMJ etc. I know because it happened to me, and my orthodontist was considered top notch.
It can cost $20,000 to reopen the extraction points and have implants put in. The effect on one's face and one's mental state is impossible to put into words. The fact that it's even legal to pull healthy teeth, especially in minors, is ridiculous. NEVER remove heathy teeth if you want to "age gracefully", in every sense of the term. It's an outdated practice that leads to lifelong health problems. The only reason to extract teeth is it makes the orthodontist's job easier and less time consuming. A pallet expander can encourage forward growth in the skull and help align teeth for people in their 20s, 30s, 40s and later. I'm surprised if you've read up on the internet about this you've even need to come here You want straight teeth but you're going to want an attractive facial structure that will actually hold your skin up even more.

Also, my partner also would say I'm attractive with a nice smile. Most people are pretty biased when it comes to evaluating the looks of people they know, but the pictures don't lie. They've done studies on twins several times, where one gets extractions and the other gets a pallet expander. Each time the twin whose had extractions for braces looks so much worse they don't even look identical anymore. If you've searched the internet you must've seen these??

Extractions CAN go poorly, but by no means is it the norm. My wife had extractions 40 years ago (she turns 50 in December) and she has a beautiful smile today. It is not an "outdated practice" and "lifelong health problems" are NOT inevitable. Sometimes there's just not enough room in the arch for all the teeth, and that's that. A palatal expander can only do so much (and of course it does not relieve crowding in the lower arch.) And of course if the palate is already of sufficient width, you certainly do not want to expand it further (this was the case with my wife.)

Certainly extractions done without either implants or orthodontics (i.e. teeth simply pulled due to decay and replaced with a bridge, nothing at all, or dentures) certainly will cause bone recession, facial issues, etc., but that's another issue entirely.

While extractions are not always the correct answer to crowding, a dentist that NEVER does them is not using all the tools available to him/her to fix orthodontic issues.

Not usually. Of course there will always be a few non-textbook cases, but for the most part it has good results. If there isn't enough room for all of the teeth, trying to straighten without first creating room can cause other problems, such as flaring of the teeth.
If your teeth are severely crowded, the extractions will provide the necessary space for your teeth to align resulting in minimal change to the arch of your teeth, thus having little impact on your overall face. However, if the crowding is minimal and teeth are pulled anyway, that *might* cause the teeth to move backwards and that can make your face look "flatter."
If it is something that worries you, talk to your orthodontist about it. They may even have some before and after pictures to show you how well it can turn out when needed.

Do NOT get your healthy teeth removed - especially 4 bicuspid. You will regret it in the long run. I'm suffering from retruded lip/chin and shallow face after undergoing extraction orthodontics. Please do not get your teeth removed. They are in your mouth for a reason. If you are under 18 go see a functional orthodontist whole will correct your jaw first AND THEN align teeth. Malocclusion is not always dental, it can be a combination of skeletal and dental mismatch. Class II skeletal overbite is best correct by moving lower jaw forward and expanding the upper palate to make room for all teeth.

overthewater wrote:Not usually. Of course there will always be a few non-textbook cases, but for the most part it has good results. If there isn't enough room for all of the teeth, trying to straighten without first creating room can cause other problems, such as flaring of the teeth.
If your teeth are severely crowded, the extractions will provide the necessary space for your teeth to align resulting in minimal change to the arch of your teeth, thus having little impact on your overall face. However, if the crowding is minimal and teeth are pulled anyway, that *might* cause the teeth to move backwards and that can make your face look "flatter."
If it is something that worries you, talk to your orthodontist about it. They may even have some before and after pictures to show you how well it can turn out when needed.

I have to agree with this statement. Think "physics." At age 15 there's a good chance other alternatives than extractions were possible & I'd defer to more consultations in hopes they are consistent with their treatment plans. But since extractions were already done, if your orthodontist is experienced and well qualified, then I imagine they chose a route that will net a good result in your particular case.

It is different for everyone. I had crooked teeth and an overbite. I had my 4 first premolars removed and it definitely improved my face (above all my profile). A treatment with 4 extractions will change your face but generally in a good way. I admit that my upper arch was a little wider before the treatment, but I prefer so much my new appearance.

I don't hide that I'd hesitated during the whole treatment about the extractions and I still have a little hesitation as my upper jaw has become smaller (I wrote a post about it, with photos). But when I see the face improvement I think it worth it.