Should I have teeth extracted or implanted?

Message

#1 Post by **Ivette** » Sun Mar 15, 2009 12:15 am

Hi! I'm new to this website (I just found it yesterday). Being new to braces too, I have to admit that I found very helpful information and encouraging stories on this website! Didn't feel how 5 hours past by today while I was reading postings here

I'm 28 and about to put braces after so many years of hesitation. However, I have a big dilemma to resolve and was hoping someone here to be able to help me with a piece of advice.

When I was about 12 I had two of my upper bicuspids removed as there was no space for them and I didn't want to hear for an orthodontic treatment at that time. Big mistake! Now as I wanna fix my teeth, my ortho told me that I have one of the two options:
1) expand the upper arch and make some space for two implants to replace the missing bicuspids; or
2) pull out two teeth from the bottom so the two arches can fit nicely

Obviously the first option would give me a nice broad smile but at a very high price - longer treatment time, much more pain, and not to mention the actual cost of the implants. My lower teeth are quite crowded and crooked anyway so I can picture having the 2 bottom premolars taken out. However, I'm concerned it may look funny to have less teeth and in a way, smaller looking jaw. Has anybody dealt with a similar decision?

Whichever path I take, I'm supposed to have my brackets attached in a couple of weeks. So please help! Can't wait to have them on...and this to be over soon!

#2 Post by **changes09** » Sun Mar 15, 2009 4:09 am

Just to give you some more info on implants. To be a good canidate for implants you have to be a non-smoker. Because if you smoke the implants will fail or not heal properly and that is a waste of money. You have to have good oral hygiene also. Now implants last forever! They look just like real teeth and everything.
My husband was in an accident a few years back....well not really an accident he was running down a hall way, the other guy was running down the oppisite hallway and they both turned the corner at the same time. Peices of my husbands teeth where stuck in this kids head! My husband insted of getting implants got more then a few teeth on the bottom taken out and also the opposing teeth on the top taken out. He got his wisdome teeth, and bicuspids taken out on both arches. You can't even tell! And if you can you are WAY to close to my husband

He was in braces for five years....but that is because he did not wear his elastics!

Good luck!

#3 Post by **kittenmaisey** » Sun Mar 15, 2009 5:15 am

Hi Evette,

whilst I'm no Dentist, I would probably go with less extractions. As you say, you want to achieve a broader smile, and extractions sometimes do the opposite.

Good luck

#4 Post by **TumbleDryLow** » Sun Mar 15, 2009 6:36 am

I have a very narrow upper arch and had lots of crowding. I was given the option of jaw surgery then expander or having 4 premolars extracted. For lots of reasons I did not want to go the surgery route. You cannot tell I have had 4 teeth removed unless I have my mouth open and you are counting teeth. I still have a small upper palate and have smaller smile then if I would have opted for surgery, but I would definitely choose the extractions again if I had to do it over.

#5 Post by **stacy19201325** » Sun Mar 15, 2009 6:59 am

I had teeth extracted as a kid, too. I know 5 were pulled that day, but I think only 2 were permanent teeth. Now I have to have all 4 wisdom teeth out, and one more bicuspid out. I feel like I'm gonna be toothless!

If I were you, I would do implants if it seemed a good option to your ortho.

#6 Post by **Audra** » Sun Mar 15, 2009 7:24 am

I also had two upper pre-molars removed as a child as I did not have room for them. This has caused me to grow up with an underbite. I was supposed to have braces as a teenager, but my parents did not want to pay for them.

I am now in braces and have not had any further extractions, so my upper jaw will have two less teeth than my lower jaw. My arches are being expanded by the braces and once my teeth are in alignment, I will have surgery to bring my upper jaw forward over my lower jaw.

I asked the orthodontist about having more teeth on the bottom and he says that it will not cause any problems as long as the front 6 teeth are aligned properly.

#7 Post by **Ivette** » Sun Mar 15, 2009 8:42 am

Thank you, guys, for all prompt responses I got from you! I feel like this is such a hard time coming for me and to get your support...it's just awesome!

I didn't want to bias your responses initially so I didn't mention what is the opinion of the professionals, i.e., my ortho and my dentist (who BTW is also an implant-specialist!). My orthodontist recommended the option with extraction as he thought it's much much easier and would give acceptable results. However, he did mention that if he'd like to make an ideal case, he'd do the option with expanding the upper arch and adding implants to achieve a broader smile. This may involve palatal expander and probably a surgery on the arch

So he didn't recommend it to me.

My dentist on the other hand, believes I'd make a big mistake if I go with the extraction. He strongly recommends that I do the implants which may extend the treatment process with about 6 months (rough estimate) and will involve expander. He says that if I shrink the lower arch, my tongue would have less space and this may block the airway to my throat (has anyone ever heard of such a concern?!) and may cause snoring and as I age it may lead to heart problems, etc. My ortho didn't mention anything like that. So I'm thinking whether my dentist is just trying to convince me to do the implants just because he has an interest in that (he is an implant specialist and of course, he assumes I'd do my implants with him) or he really has a point there. Otherwise he said I'm a great candidate for implants as I'm young, healthy and don't smoke.

Actually I'm not scared of the implants. I can do that although it would cost me another close to $9,000 in addition to the ortho treatment cost. What I'm scared of is the arch expander and I definitely don't want to do a surgery and expose myself to any risk for pure cosmetic reasons.

I haven't found a case here on this website where someone has done anything like that, i.e. expansion of the upper arch followed by implants. If you know of a similar case, please let me know.

Later I may try posting some pictures of my teeth so you get an idea of what's the exact case.

Thanks again to all of you! It means so much to me!

#8 Post by **Ivette** » Sun Mar 15, 2009 1:51 pm

Let me try posting an image of my smile (still not sure whether it would work):

[/img]http://www.kodakgallery.com/ShareLandin ... leid=en_US

#9 Post by **Ivette** » Sun Mar 15, 2009 1:53 pm

Nope. It doesn't work

Anybody to help me? How do I post an image??

#10 Post by **MakePinkNotWar** » Sun Mar 15, 2009 2:28 pm

If I were you I would get a third opinion on the issue. I believe you could go to an orthodontist and get a free initial consultation to see what they think would be better, implants or extractions.

Upload your photo to a website like http://tinypic.com and you can post it here.

#11 Post by **Ivette** » Sun Mar 15, 2009 2:37 pm

Hi MakePinkNotWar!

Thanks a lot for your reply! Let me see whether it works now...I'll try with one photo first. This is a photo of my smile...

I did see another ortho and he didn't want to hear about me going the implant route.

#12 Post by **Ivette** » Sun Mar 15, 2009 2:50 pm

Yey! It worked.

Here are more photos:

This is my current bite:

This is how my upper arch looks right now (my two premolars have been extracted more than 16 years ago):

This is my lower side (lots of crowding, one of my lower molars is out of the line):

This is how my bite looks like from the right side (the cross-bite gives the illusion I have a missing tooth at the bottom):

This is how my bite looks like from the left side (see the spacing on the top due to the missing tooth):

Now after seeing all these pictures, I really think I NEED braces! Wish I did this many years ago!

#13 Post by **MakePinkNotWar** » Sun Mar 15, 2009 3:07 pm

If the third orthodontist said no to implants then I think you should get extractions. Of course I am not a dental professional so if you are still unsure try to get another opinion or even two.

I am glad I could help with you posting photos.

#14 Post by **Neptune** » Sun Mar 15, 2009 3:43 pm

Hi Ivette! Regarding the large tongue issue, my ortho told me that that's what I have. I think it's real: my sister was told the same thing and I suspect it's something we inherited from our mother. My ortho mentioned that if we had gone the extraction route for my treatment, I may (1) nip at the tip of my tongue afterward or (2) not have enough room for my tongue to maneuver after treatment.

My odd ortho treatment consists of leaving my baby premolars in place (the permanent ones never came in) as well as my wisdom teeth. Despite this scenario, my lower arch developed with very little - if any - crowding. Treatment is primarily addressing the crowding in my upper arch.

#15 Post by **Ivette** » Sun Mar 15, 2009 5:01 pm

Hi Neptune!

Thanks for sharing that with me because I really had started thinking it was an issue made up by that dentist so he could convince me to do the implants.

What really makes me upset is that I already had my mind set up to do the extractions. When initially my ortho assessed me, he did give me the two options plus his personal recommendation, i.e. do the extraction route, but let me think about it. I didn't think much...I researched a little about implants and arch expansion but kept hearing in my mind the ortho's personal opinion. Seeing the complicated procedures online made the option about implants seem even less likely for me.

So I proceeded with planning of my treatment. Went and took all x-rays, molds, etc. Last week my ortho made great models with wax and showed me a simulated "before and after". I was so impressed by the potential results that was totally motivated to do that finally. At the end of my visit the ortho just smiled and in a joking way said, "Are you sure you don't want to do the expansion thing with implants?". I confirmed that I've made my decision to go with the extractions so he gave me a reference note for my dentist. We also made an appointment for March 31st to proceed with the brackets.

It worked just fine because on the following day I had an appointment for cleaning. As soon as I got at the clinic for my cleaning I stopped by the receptionist and asked for an appointment for tooth extraction. She said that my general dentist doesn't do extractions but she'd set me up with the expert who does that there. As soon as I sat on the chair for the cleaning, two of the dentists there (one of them turned to be the most senior dentist in the clinic who is also an implant specialist) came over to me and quickly examined my bite. Then the senior doctor started trying to convince me that I'm making "a big mistake" and should definitely do implants. I had a chance to ask just very few questions before he left. However, he did say that he won't schedule any appointment for tooth extraction until he talks to my ortho. I agreed and he was supposed to call me within two days but I didn't get any call. Tomorrow I'll try reaching my ortho and discussing this issue with him again because I'm really torn making the decision on my own.