To feel a little unsure about teeth out for braces?

[KyieveMii]

Firstly, I’m no expert so open to correction- it’s just a concern I have.

DS, 11, has my narrow jaw and palette. His teeth are crooked and his front two protrude. Orthodontics are needed to enable him to close his mouth easily/ keep teeth clean.

However the NHS orthodontist suggested removing 4 teeth. He already has a noticeabley small jaw. I worry than removing teeth and retracting the remaining ones will make it even worse cosmetically and possibly on a practical level. I see lovely wide American smiles, whereas his will curve in from his canines into a very narrow smile. Also his tongue space will be tiny.

I also worry about doing this now, at 11, when he’s late to puberty. His older brother and father developed much wider jaws at around age 15. Will teeth be gappy? Not match the jaw line? I’m missing lateral incisors so although we have the same jaw shape I can’t really compare how it looks.

my last worry is I lost two teeth, it doesn’t really matter because other teeth have almost filled the gap. If he loses teeth now then loses adult teeth will this be a disadvantage?

has anyone been through similar and can you tell me how it worked out? The orthodontist and her manner didn’t fill me with good faith, hence asking.

One of mine had their jaw broken and reset as the difference between jaws was so marked. Orthognathic surgery is brutal and it seems very hard psychologically, we found the deep bruising meant healing took a long time and it was like for almost a year every time they looked in a mirror they looked different, sometimes better sometimes worse.

In the end a beautiful smile and no regrets but never again.

American here. My daughter had a narrow palate so the ortho installed a palate expander. Once her palate was wide enough, regular braces went on. She's an adult now and has a beautiful wide smile.

I have 25 teeth, never been an issue. I’d have struggled with more, and in reality I don’t know many people who have big enough mouth/jaw for the cheesy American smile. Something more natural suits most people.

When my daughter had braces fitted I expect them to remove 4 teeth first as her mouth was very crowded. Her father and I had both had this done in our teens. The orthodontist didn't seem it necessary so they were left.
Now at 22 she's had to fork out for five extractions and 2 fillings due to the damage caused by wisdom teeth pushing their way into an already full mouth. All the work that the braces did has been undone.
Let them do the extractions.

I had similar as DS was recommended 4 teeth out too. I was nervous for health reasons rather than aesthetics. So, I asked for a second opinion to be sure. Dentist was reluctant but I pushed. Got referral to another orthodontist who said that he didn't need a brace at all, he could have one if he wanted as slight issue and he certainly didn't need 4 teeth out. He was shocked when I told him what previous orthodontist had said!

My advice is get second opinion.

I had the same done 30 yrs ago. Recently my dentist (not in the UK) said they don't do extractions any more before braces.

Think she said they've found it can cause alignment issues later in life.

NHS recommended my daughter had 4 teeth out (2 top, 2 bottom) then braces. She was terrified at the thought of so many teeth out so we went to a private orthodontist who told us that is a really old fashioned way to do it and that they should be trying to retain as many teeth as they can (it's not always possible). In Europe and the US they use expanders to make space while the jaw is growing then have braces on later once there is room. My daughter has been wearing expanders for over a year now and is just about ready to have the fixed braces (her previously very crowded teeth are lovely and gappy in places now).
Definitely get a second opinion, you will probably need to go private unfortunately as the teeth out method is faster and cheaper so favoured by the NHS!

This.

My eldest was told the same.
There was no way we were removing perfectly healthy teeth to make the job easier and faster.
It took longer privately to have a couple of mouth pieces before braces but he has a beautiful set of teeth.
It did take several years though, but absolutely worth it.

I had two premolars out at 13-14 to push my overbite back 1.5 cm. Worked. My smile isn´t narrow and really suits my face. They didn´t take any out from the bottom row because I was supposedly not going to have wisdom teeth. Only dentists notice something is missing. But they have told me that this is not the approach they usually take nowadays. This was late 80s.

I also had a palate expander, age around 14-15. I was apparently right on the edge of the size that would have required the breaking/resetting process instead, but that utterly terrified me and they agreed to try the expander. Appropriately wide mouth now - my teeth used to nestle with the top teeth nearly completely inside the bottom (so I had shift sideways to chew), now they sit correctly with the top just fractionally to the exterior of the bottom.

Orthodontists work magic, leave them to it,they know what they're doing.

My ds got teeth out at around 12/13 for braces and it affected his bite later. When I brought my dd to a (different) ortho, I mentioned it and she told me that a boy's jaw can grown until age 21, and his extractions were likely done too early. It was done about 15 years ago though so possibly treatment is better now and they allow for this. Talk your concerns through with the orthodontist, including the liklihood of your son's jaw growing significantly like his dad's and brother's.

It was done privately by the way, not NHS.

You need to trust your orthodontist or at least get a second opinion from an orthodontist

Palate expanders can be used but it depends on the occlusion, they are used more if there is a posterior crossbite rather than just a narrow arch, as if you expand the top arch and not the bottom you can end up with a scissor bite. You then end up tipping teeth and it's not easy to correcr

Honestly no one on MN can tell you whether he needs extractions or not. Orthodontics is complicated, there's many many factors taken into account when coming up with a treatment plan. Orthodontists know how the jaw will likely grow and change as he ages. They know who's suitable for what treatment, whether orthographic surgery is an option and again not always as simple as small jaw break it. Orthodontists are very highly qualified, just because one person on MNs child had no extractions, or a palate expander or orthographic does not mean that that's the right option for your child. The only person who can tell you that is an orthodontist

If you aren't happy get a second opinion

Totally agree that you should get a second opinion. Both orthodontists I saw were on NHS. You don't have to go private to get a second opinion.

I don’t feel it was a long consideration, very very fast appt with the actual ortho. Photos etc with assistant then she walked in and looked for well under a minute. It was a bit more a feeling of ‘this is what I do’.
it’s interesting reading some comments from abroad. It’s the growth that worries me. His brother at 11 had a tiny jaw and chin too, now it’s practically rectangular (like their dads). They were both physically immature (I was and their dad was too at 11 compared to English averages).
The difficultly is private treatment is out of our means

Wouldn't Smile Direct be a better option at £1600 rather than £4500 which I think is extortionate.

I have had eight teeth removed in total - I started with 36, which is four more than most adults! - so had four additional premolars removed before orthodontic treatment in my early teens, then all four wisdom teeth removed in my late teens, as even they were overcrowding.

I also have quite a small lower jaw.

My teeth are perfect now and I'm in my early 40s. I wore a combination of fixed and removable braces between the ages of about 10 and 17.

You can get a second opinion on NHS. Do some research and see if you can establish which orthodontist is popular. My second orthodontist was very popular and had a long waiting list but so glad I waited.

I had 4 out at 11 to make room for my teeth pre-braces as they were overlapping at the front. My teeth have been fine until my wisdom teeth started coming in. I’m going to need either the wisdom teeth or a tooth in front removed to make room again.

I had this conversation today with my daughter's orthodontist. I said it seemed wrong to remove 4 healthy teeth (she's having them out next week)
I was assured it was common and practically everyone has teeth removed, otherwise the teeth would protrude when corrected with the brace.

It’s so interesting, I would have assumed that orthodontic treatment was similar worldwide but my orthodontist here in Sydney was very clear that removing teeth wasn’t necessary any more. I’d get a second opinion.
having said that, I had 4 teeth removed (back in the late 80s!) and then a brace and I have very nice straight teeth and a normal smile so I’m sure even if they do remove them it would be fine.

I found this link - so extractions are done sometimes.

orthodonticsaustralia.org.au/tooth-extractions/amp/

Interesting - following as my DD is in the same position

"Two at a time over a 9-month period" 😱 Bloody hell, I think mine were 4 out one day and then 3 out two days later!