I am 24 yrs old,looking for good braces to correct my buck teeth. Basically all my teeth are OK, except the two buck teeth in front. I went to see an orthodontist for X-ray, he advised to get 4 bicuspid teeth extracted (if Damon braces is the case). OMG! All these 4 teeth are still nice & healthy. I am wondering is there an alternative to correct my buck teeth without extraction? Please advise.. Thanks!
Correct Buck Teeth Without Extraction? Damon Braces?
Doctor Answers (8)
Fixing Overbites without Extractions Using Damon Brackets
I love Damon brackets. I use them in my office on all my patients. But they are only a tool... and I admit a really cool tool (like the Swiss Army knife of braces). ANY bracket system on the market can do exactly what the Damon bracket does in experienced hands. The Damon company does not have a special agreement with the teeth and bones! I like the flexibility and efficiency of the system, but it is still only a bracket. As for treating overbites without surgery, this is an unrelated matter. The majority of overbites are caused by a small lower jaw. There are two general ways to fix them. You can either move the bottom jaw forward (surgery or functional appliance in growing patients) or you can move the top teeth back (extractions in the upper, headgear, springs, rubber bands, etc.). The decision on which approach is used is based upon many factors that are different in each patient (age, amount of crowding, size of the jaws, amount of bone and gum tissue, profile, lip posture, etc.). This is something that you can't compare with anyone else because you are unique. Have your orthodontist evaluate your situation and explain your options. The goal is the best treatment plan for you... not finishing with a specific number of teeth.
While extraction of bicuspids is less frequently indicated now, there definitely are cases where the space gained through extractions is necessary for quality results. Damon braces are basically "self-ligation brackets" that have shown some very nice clinical results compared to traditional braces but the magic is in the hands of the provider. Unraveling crowding in a non-extraction mode could force the front teeth more forward and if they are too far forward already....extraction of bicuspids may be indicated to avoid too much facial fullness. I predominately use Damon braces and love them but extractions can not be excluded as a treatment modality in (a) extreme crowding cases or (b) bimaxillary protrusion cases. In many adult cases, the patient will accept additional fullness instead of extracting teeth. Always seek another opinion if you have doubt!
Less Extractions are Being Done in Orthodontics
Without a picture, I cannot really assess the validity of the four bicuspid extractions. Your orthodontist may be seeing something beyond just the two teeth you mentioned that might indicate a need for additional space from extractions.
In very select cases, the removal of teeth can actually enhance your facial appearance, but as a general rule this is not the case. Your orthodontist should be able to explain adequately his logic for the extractions, but I'd recommend seeking another opinion just to see what another doctor has to say on the matter (don't mention extractions prior to the consultation to bias their answer).
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Damon Braces, do I have to extract four teeth?
You definitely do NOT have to have four teeth extracted to have Damon braces. What you DO have to do is DECIDE what you want your facial appearance and profile to look like in terms of lip fullness and ability to close your lips without strain. If you decide that you want to accept a fuller lip profile with the teeth more forward there is less need for extraction. As your orthodontist I have to know what you want your profile to look like and help you understand the effect that various treatment methods will have on your profile so that YOU can guide me on how you want your face to look. I have a whole PowerPoint program to show our patients cases we have treated both with and without extractions so they can see the effect that extractions will have. Extractions are not good or bad except in relation to what effect they will have on your particular problem especially in regard to your facial profile and lip fullness. Try to find an ADA recognized orthodontic specialist who will take the time to show you the difference between the treatment methods and then YOU choose which way you want to go with full knowledge of what to expect with or without extraction.
Correct buck teeth with the Damon System
The simple answer is yes. You can correct buck teeth without extraction with the Damon braces. In fact, Damon braces should be indicated if you are trying to develop the arch laterally or widening the upper arch because of the light forces that are in the wires of the Damon System. The pressure of the lips and the musculature of the lips against the buck teeth naturally drive the teeth back into their proper position. However, without the Damon System, there is no room for the teeth to move in the back. The teeth remain angulated and appear to be “buck”. Lateral development with the Damon System allows these teeth to be retracted with minimal force due to the light or nearly zero amount of friction that is in the system.
However, there are times when teeth need to be extracted. This could be due to ethnicity, the angulation of the upper and lower jaw bones, the competence of the lips. For example, the Asian population tends to be what we call bi maxillary protrusive. Meaning, that even without crowding of the teeth, extractions of upper and lower premolars are indicated in order to achieve aesthetic profile. Moreover, when the upper and lower jaws are angulated or what we call a high angle, it is very difficult to be able to close the bite anteriorly and this leaves to what we call an open bite. Sometimes in this situation, it is necessary to remove bicuspids too to help correct the buck teeth. And lastly, if the patient is not able to close the lips, we call this lip incompetence. This too is sometimes an indication to remove the teeth to be able to correct the buck teeth. However, it is our preference any way possible to be able to correct buck teeth without taking any teeth out which is what the Damon System is known for.
Neither extractions or Damon Braces are necessary for good results
Even though extraction of bicuspids is still necessary in some cases, it is not always the only option. If the doctor has not explained in a logical manner the reasons why, it is a good idea to get another opinion to see if they collaborate. It is still sometimes the best way to treat some cases.
Damon braces are one type of self-ligating brackets. Self-ligating braces such as Damon tend to allow teeth to be moved faster than conventional braces with less effort and less pain. But keep in mind, they are just a handle. The real result comes from the hands they are used by, and other types of braces will give excellent results.
Trends are now moving from taking out teeth for braces
At one time it was pretty routine to take out certain teeth before orthodontic treatment to create space, but that practice is now diminishing.
Long term adverse effects, such as the arches of the jaws collapsing, were becoming more frequent, so many dentist now choose to extract only if completely necessary.
If you are unsure of the treatment proposed to you, seek out another opinion to help you make this important decision.
Extractions for orthodontics is becoming less frequent
I would suggest another consultation, as old habits die hard. In years past, extracting 4 teeth was routine, but we are finding that the effects last a lifetime, and not always good.
Sometimes there is no other way, but most of the time there ARE alternatives.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.