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FAQ:  Orthodontics - Children - Teens

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Orthodontics Ask The Orthodontist Ara Nazarian Question:
Pull 2 first bicspids to make up for right canine? I am a 20 year old female who is getting braces because of crowding in the bottom front portion of my mouth.

Also I am missing my canine tooth on the top right. My orthodontist suggested pulling 2 first bicuspid left teeth (top and bottom) to make up for the missing right canine tooth.

I'd like a second opinion, is this logical? ...Visitor from Canada

Many times in order to gain spaces, orthodontists prefer to have teeth removed for access. This has been done for many years.

However, in some instances the removal of teeth is not mandatory to enhance a smile. In my Fast Braces technique, I gain spaces by slightly slenderizing the teeth in order to gain space.

We always stay in enamel so that the teeth that are slenderized are not sensitive or unprotected. As a restorative dentist, I also look at what the final result will be.

In other words, not having a canine present means your smile will be asymmetrical. Is your midline (the space between your two front teeth) straight and centered? ...meaning if you drew an imaginary line from nose to chin, it should line up.

Another option is to shape the tooth in the canine area like a canine or have veneers. Without seeing a picture of your teeth, it is difficult to say, however, there are many orthodontists that may offer some other suggestions.

Most importantly, I would not do anything until the whole treatment plan has been layed out by orthodontist and restorative dentist with a lot of communication and then have them present it to you or you can have a restorative dentist who does a lot of ortho like myself do the whole thing for you.

It is sort of like building a house with a bunch of contractors. You need a blueprint, picture, or diagram before they even start digging. Many times I have patients come to my office dissatisfied with the final orthodontic result because of poor planning and explanation to the patient.

A Nazarian, DDS

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