Do DC really need teeth removed for braces?

[Iydrd]

does this not seem excessive? My DH had some teeth removed when he had braces and now he has gaps. dD due to have teeth removed for train tracks to be fitted on NHS. But when I got frustrated with the long wait I got a quote from
Invisalign and they didn’t need to remove
teeth even though she was a severe case. Can Invisalign really do a proper job or should I just suck it up and let her have teeth removed? She has a small jaw and an overbite. I’m just scared to allow the teeth removal to go ahead!

I dont think healthy teeth should be removed. I think its an NhS thing.

How old? We were told the best time is 13/15 after all baby teeth are gone and when the mouth is in the shape it’s going to be in. I’d heard of kids getting it done younger but it’s only when there’s a huge issue. Have heard bad stuff about Invisalign for kids.

Nope. Palate expansion needs to be performed prior to braces, rather than extractions, so a 2 step process.

ps having teeth extracted is a routine thing if I’m to go by a lotttt of people I talked to before ds got braces for a load of different reasons to do with shape or overcrowding of back teeth. Everyone I know that had it done it wasn’t a big deal at all

HoppingPavlova
They still do palate expansion sometimes when they’ve removed teeth, it’s just based on the child (dn had teeth removed and this done, no problem)

My children with extremely narrow jaws are having early treatment while they still have some baby teeth and their jaws are growing. Invisalign equivalent. It looks like they will get away without extractions. But the key is that it’s early while their jaws are growing - I’d question whether it’s possible to avoid extractions that would have otherwise be needed once all their adult teeth have come through. In your case I’d maybe get a second opinion. Perhaps they do have the space and can avoid it.

I had this done on the NHS as an older child/early teen 25 years or so ago: a tooth removed from each side, upper and lower, then fixed braces, as I had quite a big overbite. No gaps now, and it's never caused me any problems (have never had to have any other teeth removed due to decay or anything), but no idea if it's still considered best practice now. I would have thought though that invisalign would only straighten the teeth, not reduce an overbite, but may well be wrong!

(Edited to clarify I was probably actually about 11/12 when I had the extractions, I think)

Never heard of this.
I only know that they used to remove wisdom teeth, but even that has been scaled back...
So, unless they are riddled with cavities, I would not consent to the removal of any teeth.

Both my dc had nhs braces and only ds needed a baby tooth removed to pull an adult tooth into place.
I had braces as a teen and 2 teeth removed and I have gaps now. They give retainers now to wear at night after braces, maybe if I had them I wouldn’t have gaps 🤷🏼‍♀️.

I had four removed at a private dental practice prior to train track braces being put on. This was due to overcrowding, and my teeth were going to have to do a lot of movement to finally be straight. They would not give me fixed braces until my jaw had stopped growing. Due to the original positions of them, I was told that I would have to wear a retainer for the rest of my life. I don't have any gaps.

Yes, maybe this is key - I've continued to wear my retainers pretty much every night since as I remembered the orthodontist at the time telling me this was key to prevent them 'drifting' 😁 . Have had to have new ones made a couple of times as they eventually break.

I don’t personally like the NHS approach of waiting til they are teenagers, whipping teeth out and then straightening in the space there is. It doesn’t address other issues caused by narrow jaws, like mouth breathing. In Europe and the US it’s much more common to start treatment earlier, make space for the teeth as they come through and their jaws are growing, and then straighten up again a bit later if necessary. My two now have almost perfectly straight teeth and you can see how much ‘rounder’ their jaws have become. They will still need treatment again later once all adult teeth are through but hopefully won’t need extractions.

My kids only needed baby teeth removed. My understanding is it’s a bit extreme to have healthy adult teeth removed.

Entirely agree

It would be so, so much better to use palate expanders at an earlier age where indicated, rather than having to take healthy teeth out later. For many reasons, a wider palate is better for breathing and face development as well as just teeth.

DD had an expander in year 4 as I knew she had a narrow palate and would get overcrowding later. Had to go private for it though.

I did and have been stuck with horrible gappy teeth ever after. I still feel angry that two perfectly healthy teeth were removed like that when I was a child and had no say in the matter.

I had palate expansion and 6 perfectly healthy teeth removed when I was 12, followed by braces top and bottom for 18 months. I was left with gaps in the bottom; I think they left room for wisdom teeth but they never came through so I've still got gaps. This was mid 80s NHS though.

I knew dd would end up needing braces- her overbite has been clear for a long time. She only just got to the top of the nhs waiting list age 14.
i am gutted as I was t ever aware of things to make the jaw wider.

it’s definitely genetic as she has the same overbite as dh had in photos, but she admitted to the orthodontist that she was a thumb sucker and the orthodontist won’t listen to use when we say it’s from her dad who never sucked his thumb whereas I still sometimes find myself doing it and I have perfectly straight teeth and just a very high palate.
my mum has offered to pay for Invisalign. Dd is fine about having train tracks but I’m really uncomfortable with the tooth extraction

I had four teeth removed for braces when I was 11. Looking back at photos, my teeth weren't even thst over crowded, it just seemed to be the done thing for braces at the time. I'm not sure I'd want dds to have the same done, especially not while their jaw was still growing.

I also didn't wear my retainer much! It was really loose and fell out while I was talking and would wake me up in the night as both the top and bottom ones had fell out. I told the orthodontist but he said it was normal for them not to be tight, i couldnt seem to get it across thst they would not stay on my teeth. So I gave up wearing them.

I only have 24 adult teeth as the rest - as well as a bunch of baby teeth - were pulled. My DC had palate extenders and still have all their teeth. Things have moved on.

I had four healthy adult teeth removed as a teenager followed by train track braces. I now have really good teeth and no gaps.

Images on the left what she has now and right hand side what Invisalign reckon they could do

When I had braces I had teeth taken out. I have straight teeth but a very narrow palate and issues with snoring, sinuses, etc. My son recently had sparks (like Invisalign) and it was all about widening the teeth. His smile is amazing, his teeth fill his smile whereas I have black triangles. I could even see his jaw shape changing nicely. He's all wide and squared off.
I think the taking teeth out is the old way of doing it. If your daughter has a narrow palate then it's not a good approach for airway health.

Same here - one of mine was a thumb sucker and the other one not. The orthodontist was astounded when I said the younger one had never sucked his thumb. It’s genetic. I had teeth out, and now have a much narrower jaw than they will do. And I do breathe through my mouth.

What I would say about Invisalign is that the children need to be compliant. It’s another reason they like to start early. She might have elastics or other attachments and it won’t work if she’s constantly taking her aligners out to eat, drink or for cosmetic reasons. It’s another reason orthodontists like to start early - while children are more likely to do what they are told! Fixed braces obviously take away that issue. There’s nothing special afaik about Invisalign over fixed braces - if she’s got space for the teeth then both fixed and Invisalign should be an option without extractions I would have thought. So maybe something to think about if you get a second opinion.

I have a small jaw. I had to have teeth removed because my jaw was overcrowded. I have also had all of my wisdom teeth out. I have had 8 teeth out in total to reduce overcrowding. I also had another out a few years ago due to an infection, so where this tooth was removed is the only gap in my mouth.

I had four healthy teeth,two in each row, removed for a brace. I had buck teeth due to thumb sucking. But that was well over 50 years ago. The two top teeth removed were the ones next to the front teeth.I’m 65 now and my gums have shrunk with age,and my two front teeth look disproprtionately large compared to the ones next to them. I’m self conscious about this and try to cover my teeth when smiling.

My two don’t even need palate expanders. I expected them to but they are doing it all with aligners and elastics.