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I have been going back and forward for past few years on getting braces and I have been lurking on this board for a few weeks now...I must say the information on this board has proven to be very useful .
I have gone to 3 ortho's. 2 of them said that I would have to have 4 pre-molars extracted. 1 of them said I could choose between having 4 premolars extracted or filing my teeth to create space and not have any extractions.
Have any of you had your teeth filed instead of having extractions? Are you happy with the results?
And for the ones that have had teeth extracted, are you happy with how your smile is now? I guess I'm worried that by having the premolars extracted my smile would look weird, since I have a wide smile and by having the premolars extracted, the molars would be showing much more since they will be next to the sole premolar.
I don't know what kind of orthodontists you've been going to...but you need to keep looking for another one who will not recommend extractions or filing. My opinion as a nonprofessional is that you don't need extractions or filing. My teeth were much more crowded than yours and my orthodontist didn't even mention extractions or filing. I only wore a palatal expander for a few months and I've expanded 6 mm, and everything is working out perfectly, there is enough room in my mouth for all my teeth.
As I can see your teeth are very healthy and also very white. In my opinion, your teeth are beautiful. I don't want to discourage you from getting braces, but if I were you, and was presented with the only option "to have 4 teeth removed", I honestly would decide not to get braces.
P.S. I am very curious to hear the professional opinion of one of the doctors on this forum about your case.
Obviously a full diagnosis and treatment plan cant be made here but by the look of your teeth I would likely opt for the IPR (slenderizing, stripping, reprox -- or filing as you called it) In this particular situation I think it will help create some space of course but I think the real value will be in improving the tooth shape so you can have more overall balance to the final tooth size in your new smile. take a look at your 2 front teeth -- the part away from the center line...do you see how that edge is quite flared out and rounded. that scenrio can lead to black triangles at the gumline and make the front teeth look extremely large relative to the other teeth destroying the overall balance. So some reprox and reshaping could reap huge dividends in your particular case IMHO.
Wow the side view of your teeth looks exactly the way mine did before braces. My original ortho told me IPR would not work in my case, only extractions. The second Dr. I saw who looked at my before pic told me I could have benefitted from IPR and Damons, after my extractions. Do the IPR.
For the purposes of dental crowding, it doesn't appear that extractions or filing are 100% necessary to align the teeth. However, when taking into consideration profile, which cannot be determined without full facial photos or a clinical exam, the story may be quite different. You will have to determine what you want out of your treatment in terms of facial profile, stability, lip balance, etc.
As Dr. Rick mentioned, the shape of your front teeth seem to fan out from the gingival margin towards the incisal edge and may benefit from some reshaping. Even with IPR, you may still benefit from extractions.
Fortunately, in this position, you may be able to line up your teeth first, and extract after alignment so that you can get a better idea of what your teeth will look like without removing teeth.
Best of luck!
Dr. Jason Tam
Toronto Invisalign, Scarborough braces, and Markham Orthodontist
Diamond Plus Invisalign Provider
Thrice Published in the Invisalign Case Gallery
Thanks for the replies. We only have 3 ortho's around here. I'm going to do a second round at two of them and have them set up a definite treatment plan and then choose whether I'll go through with it or not.
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