AIBU to hate myself for okaying DS's permanent canine tooth extraction?

[hollsh]

Have felt completely useless as a parent since yesterday, so been searching mumsnet for similar issues, but can't find anything that exactly fits... Hoping someone might be able to offer advice?

DS (15) has always had really bad teeth - not bad in terms of decay etc., but bad in terms of looking quite badly messed up. Baby teeth were late coming through, as were permanent, and then baby teeth blocked permanent etc. etc. We always knew he would need a brace - question was when not if. Got referred several years back to orthodontist. First one we saw seemed really nice, but just kept calling him back each year to check on progress of him losing baby teeth. It was getting to the point where we thought some baby ones might need to come out, but then they kept bumping his appointments - and then covid happened... Once they started appointments up again, they put him with a different orthodontist - as they said it would be an even longer wait for the original one. I wasn't mad keen on this plan (long story!), but we went along with it anyway, as the alternative wasn't great either.

They sent him to have 2 baby teeth removed, and then he had his lower brace fitted. So far so good. Then they said he would need 2 permanent teeth removed, and referred him to normal dentist for this. The appointment for this was yesterday.

About a week ago DS said he was worried as they would basically have to dig one of the teeth out. It sounds crazy but I hadn't really thought before about how impacted some of them were. I started panicking a bit at this stage, thinking maybe he should be having this done in hospital, so I decided to just double check it with the dentist when we got there - the other tooth seemed like quite a straightforward extraction anyway, and I didn't see any problem with them taking that one out, so I knew it wouldn't be a wasted appointment.

When we got there the dentist himself seemed quite apprehensive about it all, and I asked him whether DS ought to be going to hospital for the impacted tooth. He took two x-rays and then said he should be ok to remove them but that the impacted one was a canine so would have a longer root. No one had spoken to us about it being a canine extraction previously and, to be entirely honest, I was more concerned about it being impacted at the time. I don't think I was really thinking straight at this point, and already felt like I'd been making a bit of a fuss.

As it was, the whole thing was mercifully very straightforward, and DS did not even need paracetamol last night. But, after the initial worry passed, I started thinking it might look a bit strange having a missing canine tooth, so I hit google... And that's the point at which I started to feel completely useless.

Basically, it now looks to me (without knowing anything about this at all) that permanent canine tooth extraction should be an absolute last resort. And that even a very high, impacted, canine tooth can be brought down with some kind of chain device? So now I'm thinking why didn't they remove a premolar, as they have done on the other side, and try to bring the canine tooth down into the gap? And why didn't anyone speak to us about the seriousness of this? Shouldn't DS have been referred to the hospital orthodontics team to explore alternatives, if this really was such an extreme case?

I am literally sitting here shaking and crying that I have allowed this to happen. I feel so ashamed. DS is blissfully unaware of any of this and is just pleased he has no pain and is one step closer to straighter teeth. I know there is nothing I can do now about what I have already allowed to happen (that's obviously why I feel so terrible). I don't even blame them really - I blame myself for not being more 'on it' over something so serious.

Really I'm just looking to see if anyone has a similar experience and what I should do next? Should I query this with the orthodontist/dentist? It's too late to ask for a second opinion about what has already happened, but should I ask for one for the next stage? How would I even do this? Is this so bad that I should make a complaint? What about other kids? What should DS's future treatment look like? Should we push for a canine implant? (seems crazy, given they have just taken one out, but still...)

Obviously, the internet is a pretty scary place, and I have been reading stuff that says this will literally mess his face and jaw up - is there anything sensible I can read on the subject?

If you're still here, thanks for reading this far - and thanks so much if you are able to help at all!

I had one of my adult canines out when I was a teen. I’m fine. I don’t have a lopsided smile -you wouldn’t notice unless I told you.
It slightly bothers me when I remember but only in the same way that not being three inches taller bothers me.

It’s so hard isn’t it. My DCs have all had braces but only one had to have teeth removed (3 in all, they waited to see if a 4th needed removing to, but luckily it didn’t).

DS was an absolute star about it, especially as one of them broke and the dentist couldn’t get it out so had to call in reinforcements!! My palms were absolutely sweating but poor DS was just sitting there with two dentists pretty much kneeling on him desperately trying to prise this thing out!!

When I was initially told of the plan I started googling about orthodontist treatment and reading about Damon braces which apparently the Americans use a lot and don’t need teeth removing. When I spoke to the dentist and asked if there was an alternative to removing teeth he replied “Yes. Don’t have braces” He was henceforth known as Mr Grouchy, and they dreaded his appointments but all the others there were lovely and talked us through it all, what they were doing and why etc. Obvs covid protocols haven’t helped as I wasn’t allowed to go in with them, had to wait in the car, so the last few appointments I’m relying on them to tell me what’s going on.

I’m sure your DS will be absolutely fine and they’ll have good reason to have extracted that tooth. It really is a bit of an art when you see them choosing which types of fixings to use and how they’re going to manipulate each tooth into place. Have faith.

I had canine teeth taken out and I have straight, even teeth. Please don’t worry. You and he will be glad you took this decision.

My canine teeth were stuck in my gums and when I was 16 I had surgery and chains were attached to them and they were pulled down with braces. It was painful.

I was left with an over bite and life long painful TMJD. So in my experience this option was not one I'd want to have again.

Don't wait til the next appointment, the orthodontist might have tight appointment times for the treatment being done and the extra cleaning now needed, so not have time for a longer explanation. Phone the reception and ask to leave a message that you wouldold like the treatment plan explained, either via a call back from the orthodontist when they have time or relayed through the receptionist. This will give you time to take it in and then if you have further questions you could ask them at the next appointment.

I'm not upset because I have allowed him to have permanent teeth removed (I realise this happens all the time), I'm upset because I've allowed him to have an adult canine tooth removed, and never queried this, when I realise now I ought to have done

But OP, many people on here are telling you that they’ve had upper canines removed and that it’s no big deal. If you look at my upper teeth I’d bet you wouldn’t even notice I didn’t have canines - the pre molars look v similar. You don’t need to worry!!

I think OP is upset because she did not give informed consent. I.e. she feels she didn't understand fully the purpose of the proposed treatment, pros and cons and any alternatives. This is understandable. I would feel the same way. I think you should call the reception of the orthodontist and say that you want your son's treatment plan explained to you. He has had teeth removed that you didn't think would be removed and are concerned about this. Say you didn't feel things were explained to you properly. Ask for either a call back or appointment to see him in person. If they fob you off then I would write this in a letter/email addressed directly to the orthodontist. They should take this seriously.

I had an adult canine removed in my teens. I’d pulled out the milk tooth when I was about 10 and the gap almost closed up as the canine did not appear for a couple of years. By then there was nowhere for it to go so it appeared in the upper gum. There was nothing else for it but extraction - far better that than have it protruding above the other teeth as I have seen with some adults. The gap later closed completely so the first pre-molar could be mistaken fora canine. Dentistry is now far more sophisticated than in those days so I’m sure a dentist wouldn’t remove the canine without good reason.

Really don’t worry, you are right taking a canine is a less common treatment plan but because of that it will have been one of those situations where it was clearly the best/easiest treatment plan. The orthodontist won’t have drawn your attention to it because it was such an obvious plan there won’t really have been a viable alternative it will have been either these teeth out and ortho or no treatment. I’m going to try and make a comparison, say you had a rotten wood window frame that was letting water in. You could get it repaired, treated and glass replaced etc. Taking a lot more time and 5 times the cost and a rubbish result that failed quickly, the window person will just say it will be x amount for a new window. Sorry any window fitters if that’s a load of rubbish!

The dentist will have been a bit apprehensive because we almost all hate ortho extractions at the best of times, taking a sound tooth out is always a bit unsettling. Your dentist will almost certainly have spoken to the orthodontist to just double check the treatment was correct.

The few times I have taken canines out the final result has always been brilliant. Definitely ask for more explanation as to the treatment plan but try not to worry in the meantime.

Removal of an impacted canine is a perfectly valid treatment plan, even if its a tooth that can be bought into line with a gold chain. Honestly Op no harm has been done

If you remove the premolar theres always the risk that the gold chain bonding doesn't work and the canine cant be bought into the space, youve then essentially lost both teeth and are left with a gap. Some canines are very unfavourable and a gold chain is not a feasible option, this may have been the case for yours

Normally its parent/patient choice with impacted canines as to whether you remove it, try to bring it down or leave it in situ. In your DSs case it maybe that these weren't all valid options. Think of it this way, he's losing a healthy tooth whether its a premolar or a canine. You have done nothing wrong, his teeth will be fine

However if you genuinely feel that you weren't aware it was a canine, and that no one has discussed the fact it was a canine with you, or explained the rationale behind removing it then I would be contacting the orthodontist, as whilst as I said its completely valid it should be patient choice, and I would question whether they had proper informed consent. I'm not sure Id be happy to remove the canine in this situation, purely because you were not aware it was going to be a canine. I think you need to see the orthodontist to enable them to properly explain the treatment plan to you, so youbundersyand and can see what the plan is going forward.

Your DS seemed to know it was impacted, could it be he has taken in information at the appointments youve missed?

Oh my god I had my two adult canine teeth removed at 15 and I went out the back exit of my dentist and went to my orthodontist office and had my braces applied. I needed room to have my overbite sorted. Yes I had chains and rubber bands and headgear-it was 1989. No issues at all

You need to get a grip OP. I had my top two canine teeth extracted by the dentist when I was quite young - plus several other teeth - and it's never been an issue. The only people who have ever noticed are other dentists. What exactly do you think is going to happen?

I also had my upper canines as a teenager - massive overcrowding and they were growing horizontally above the front teeth.

I have completely normal / nice looking teeth, the pre-molars just moved into the gap (with the help of braces). Only thing I can't do is 'tear' food like pizza.

'Upper canines REMOVED'

I personally would get a second opinion on this and preferably with a orthodontist just to double check everything and to put your mind at rest.
But don’t panic just make a Appointment and I’m sure everything will be fine .

Thanks everyone - your messages really helped me get some perspective... ViceLikeBlip - sounds like my son had exactly the same teeth removed as you did, so your post was particularly reassuring! I'm still not happy about what has happened, as there was definitely not informed consent on my part, but I will just have to make sure I'm 100% clear on everything going forward. We have an appointment in a couple of weeks and I am going to approach it from the perspective of how they are going to manage the difference of him having a canine on one side but not the other - there doesn't seem much point in banging on about the rights and wrongs of them taking the canine in the first place, as there's absolutely nothing that can be done about it now anyway. Thanks again to everyone who helped and sent messages of support.

Hi op. My DD has just come out the other side of impacted canine treats at the age of 17! Her was on one side only. At orthodontist for general straightening braces but they wanted to wait for all baby teeth to fall.Waited ages for baby canine tooth to fall out then they did an x ray and realised why. Referral to hospital for procedure to fit tiny gold chain to tooth high in upper jaw. Was a day op and wasn’t as bad as feared. It finally appeared through the front of the gun so they didn’t need the chain and just attached it to her train track braces with elastic initially. This was after months of making a bigger space. Covid then slowed everything so they were on a lot longer than needed. I hope you get the answers you need. We certainly went through a lot of paperwork before they agreed to treat her. We were made well aware of the potential problems.

As far as I know, they can shape the next tooth along to look like a canine aesthetically.