Extractions VS Slight Flaring

[DarkAlleyCat]

Hi!
I would like to hear from people with mild crowding who had their 2nd premolars extracted for braces. I have been wearing braces for about 6 months, and they pushed my front teeth out some, although my lips look fuller with my mouth closed, I hate it when I smile. I talked to my orthodontist, and he said it's a matter of preference and if don't like the flaring I will have to have four 2nd premolars extracted to make room.

I have been reading on how tooth extractions can leave you with flattened facial profile and such, and I according to my orthodontist it is hard to control how far back your teeth will move, since I don't want them to move too much in, he decided on taking 2nd premolars instead of 1st ones. I am worried as I don't want to end up looking like a toothless person, having teeth flaring out of of my mouth is not pretty either. Thank you!

[Reflektor]

I had four 2nd premolars extracted before I got braces and sadly I look the same as I did before.

[DarkAlleyCat]

[quote="Reflektor"]I had four 2nd premolars extracted before I got braces and sadly I look the same as I did before.[/quote]
Do you have the extractions opening closed by now? So your face haven't changed at all? Did you expect it to look different?

My goal is to preserve facial profile I had before braces, my bite was good. I had some crowing both upper and lower, upper canines were sitting bit high.

[coreym95]

I had my 4 premolars extracted and all looks normal to me. I wore braces for a year before they were extracted. My Ortho thought there would be a chance we could avoid it, but couldn't. I'm glad we did it, because my once my bottom teeth were all aligned (before extractions) they looked way too far forward. It almost looked like I was wearing a mouth guard they stuck out so much.

[plugnickel69]

I have definite feelings about this. For the record, I had 4 premolars extracted as a teenager when I had my braces.
Had braces again almost 50 years later. Happy with the results both times. No sunken face.

I remember one girl during my high school years who really had that sunken look and obviously had extractions that may not have been needed - but that was 50 years ago. Today new methods of expansion and IPR often make multiple extractions unnecessary. That said, it's also a matter of physics. You can only expand so much if expansion is even a possibility, and you can only remove so much tooth structure with IPR. I sometimes see people these days, some on this website, who had their orthodontic work done without extractions, but to my eye needed extractions. To me, the results look like they need braces as they look like they have a significant overjet, especially from the profile view. Some people want that toothy smile, but you can have a toothy smile without looking like you need braces.

We all have our own opinions. In the end it's important for us to be happy with our own results.

[sirwired]

If it were my mouth, I'd go for the extractions; flare would really bug me. If there isn't enough room, there isn't enough room.

[DrJasonKTam]

The rationale for removing 2nd molars to reduce the amount of profile change is a good one.

To reduce flaring without extraction, it may be possible to IPR between the teeth to retract them slightly.

All of this being said, extractions do not ruin the face. The treatment method by the orthodontist is what really matters. If you think about it, closing an extraction space can be done by moving front teeth back, back teeth forward, or a combination of both. It is the control of this movement that will determine how much facial change is present.

[DarkAlleyCat]

Thank you all very much for your replies. I had a talk with my orthodontist and that's what we decided to do: after I have extractions done and braces put back on, I will have to closely watch how my front teeth move, once they are where I want them to be I will go to the ortho. and he will stop them from moving any further, and then close the remaining space by moving back molars forward.