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FAQ:  Extraction Orthodontics

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Is removal of bicuspids normal? My son has a 9mm space between upper and lower teeth.

At age 9 to 10 yrs he wore braces and head gear that helped reduce the flare. We moved before his "second phase" treatment started. The 2nd phase was to include full bottom braces and continued use of the head gear. Our Orthodontist hoped to reduce the overbite to around 3mm.

Our current orthodontist removed his old braces for three months to allow some baby teeth to fall out. They did not recommend a retainer. His teeth are now exactly where they were before his 18 months of treatment.

The current Ortho said that the only way to get anyplace near a 3% space would be to extract both upper bicuspids. Do you think removing teeth is a good idea in a pre-teen? ...Visitor from Minneapolis

Extraction orthodontics is a controversial procedure.

Extracting teeth is a "short cut" attempt to achieve an alignment of teeth between the upper and lower jaws.

The consequences of "extraction treatment" can be devastating for some patients. Many adult patients, who underwent extraction orthodontics as a child.... rely on implant dentistry to re-create what is "expected" in a normal smile.

If the issue is simply one of "not enough space" removal of pre-molars or other posterior (rear-most) teeth could achieve the same result without distorting the "normal smile" elements.

It is likely, VERY likely, that that the "jaw sizing differences" between the upper and lower jaw might be BEST addressed with orthognathic surgery whereby the differences in jaw bone size and growth are addressed through oral surgery.

It may be very helpful for you to get a consult with an oral surgeon or two, who routinely perform orthognathic surgery.

Editorial Staff

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