13 Year Old Needs Braces and I Have to Choose Between Extracting 2 Teeth or Getting 2 Implants?

I took my daughter to an orthodontist to talk about braces. Her xray showed that she is missing 2 front lower teeth and never growing in,they would be #24 and 25. There is some separation on her teeth there and he mentioned 2 options. He can extract 2 upper teeth and then bring both lower and upper teeth closer with the braces. Or He could do 1 or 2 implants in place of the 2 missing lower teeth. I dont know which option is better. I think he prefers the extraction, but I'd like other opinions.

Doctor Answers 1

Dealing with missing teeth

The esthetics of her smile are going to drive this treatment plan. If the upper teeth are not severely crowded or flared forward now, then moving them back may not be desirable. Creating a deficiency in the upper arch to match a deficiency in the lower arch may compromise the final result.

If implants are planned, then their desired final location, and the quality of the bony ridge will need to be considered and managed during the orthodontic treatment. Key for the best possible outcome is close coordination now between the orthodontist, and the dentist & oral surgeon in charge of tooth replacement.

A third option besides the lower implants may be to close the space from the back by moving all the lower teeth forward, using TADs anchorage with miniscrews or miniplates. From an orthodontic perspective this would be the most involved treatment plan, possibly requiring more orthodontics at a later age to align the lower wisdomteeth.

There are a lot of factors in your daughter's case, and I agree that getting additional opinions would be very helpful, including from the doctor that would potentially be replacing the missing teeth.

San Ramon Orthodontist

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