Metal Mouth Message Board

I'm 51 and doing this for the first time. I've had two orth consults. My lower teeth are very crowded and one sits back much more than the others. First ortho said remove lower incisor...Second ortho is against that, says he can do it with IPR, making room shaving teeth down, wants to keep things even. Looks too crowded to me for that, but I guess he knows what he's doing. So now that leaves me not knowing what to do and which orth to go with. Any thoughts and experiences with extraction vs. IPR?

I personally had extractions. I had 4 premolars plus 4 wisdoms extracted. The wisdoms had to go as they were impacted and one was even causing a cavity in my 2nd molar. I had moderate crowding top and bottom, and I also had a deep overbite plus protrusion.

I was initially apprehensive about extractions and wondered if I needed that much space. But now that the spaces are closed and I can see how much movement I had to get rid of the protrusion, I understood why extractions were needed and that I had initially grossly underestimated my protrusion and crowding problem. So, no regrets for me. As for Ipr, it was never an option for me so I don't have any experience to share.

As mentioned in my previous response to your other post, whether ipr will work for your case depends on how much crowding you have and how much space you need. If you do choose to go with ipr, do ask your ortho about the possibility of getting flared out teeth as it seems to sometimes happen in ipr cases. If you can't decide, perhaps consider seeking a 3rd opinion?

I'm sure there are cases that warrant extractions, but I would be careful. Here is a video I saw on YouTube which would scare me if faced with this decision...

https://www.youtube.com/watch?v=cvJKTmXwskA

My personal experience with multiple consults is that one said they must do extractions or else surgery aka no other option and the other said they had complex cases like mine and would start with no extractions, and then later down the road if it didn’t turn out well, they would opt for the extractions. I went with the latter and trusted his vision but also loved his honesty about the possibilities. In the end I didn’t need them (did IPR) and glad I went with option 2. No one likes to pull healthy teeth (unless of course you’re getting paid to do so lol).



If you must, go to a third consult! Orthodontistry is very much a science but it is also an art sometimes. Even with the same beginning smile, you may end up with different but reasonable outcomes with different professionals.