To feel a little unsure about teeth out for braces?

I don't have any knowledge of the tooth removal issue. Like you, I was taken aback when the orthodontist mentioned it as a possibility for my daughter, but luckily it wasn't necessary after all and she just had a fixed brace.

But I will say that my daughter found orthodontic treatment difficult and somewhat painful, and in retrospect I'm glad it didn't happen when she was ten, which would have been possible and which I was pushing for - I wanted to get it over with. She was 12.5 when it started, and she needed that extra maturity. Cleaning round the braces properly is hard work. There were some foods she couldn't eat for years while she had the braces on. Every six weeks when they were tightened, it hurt for a few days. She felt rather overwhelmed for the first four months or so, and I don't know that she would have coped any younger. So you might want to consider putting it off for a while.

And along similar lines, I'd suggest trying to time it so that your son doesn't have too much else going on in his life when he first gets the braces. For example, IMO it could be a bad idea to do it just as he's starting secondary school, or moving house, or anything major like that.

I was in a similar situation at a similar age and had 4 teeth removed before having braces in about 2000 or 2001. My teeth and smile look "fine" now but I definitely notice a difference to other people's smiles. Mine is short.. is that the right word? My arch is quite narrow now and when I smile there's not much of my top teeth that show and there are gaps at the side of my mouth and sometimes in photos you can see my molars in the back of my mouth. My top teeth stayed straight but my bottom front teeth have moved a little and I looked into getting invisalign a few years ago. I got quotes from 3 different orthodontic dentists and they all said that my jaw is so narrow now that the invisalign might not work and that nowadays they don't remove teeth for braces like they used to.

It's definitely not the end of the world and I'm happy with what my teeth are like overall but I was left to feel like those teeth probably didn't need to be removed so now I wonder "what if.." 😥I gather there have just been changes and advancements in techniques in orthodontics and teeth removal is not as standard as it used to be.

I think you'd be very reasonable to get a second opinion 🙂

Your concerns sound understandable, especially when your son already has a narrow jaw and palate and is only 11. Four extractions can feel like a major decision, but whether they are appropriate depends on his individual crowding, bite, tooth positions, facial growth and the overall orthodontic plan. It isn’t necessarily the case that extractions will make his jaw physically smaller.

I’d be inclined to seek a second orthodontic opinion before making an irreversible decision. Take along his X-rays, scans and proposed treatment plan and ask specifically why four teeth need to be removed, whether there are suitable alternatives, how his expected growth has been considered, and what they anticipate for his final bite and smile.

The fact that his father and older brother developed more jaw width later is certainly worth mentioning to the orthodontist, although family growth patterns cannot reliably predict exactly how your son will develop.

A general dentist may also help you understand the wider dental considerations. Shire Doctors and Dentists in Caringbah provides children’s dental care, so it could be another place to discuss your concerns before proceeding, without assuming extraction or expansion is automatically the right approach.

If the first orthodontist’s explanation didn’t leave you confident, getting another professional opinion seems very reasonable.