Should I have 4 bicuspids extracted for orthodontic treatment?

Question

I'm a 22 year-old orthodontic patient with an anterior open bite. I've had a palatal expander and mini plates that are going to be removed soon that have helped close my bite by molar intrusion. At this point I'm supposed to schedule a consult to have 4 bicuspid extractions to avoid jaw surgery, but I am hesitant about the facial effects of so many extractions. My face is already narrow and flat and I don't want that to worsen as a result.

Ira Shapira, DDS · Answer

You have not provided any photos or documentation.

In general ,it is almost always a mistake to amputate healthy body parts.

I would suggest evaluation by an oral Myofunctional 
Therapist as a first step.  Open bites are frequently associated oral habits.

Orthodontics has already failed you by not providing early interceptive treatment usually before 8 years of age and ideally much sooner.

A thorough airway evaluation should be done because extractions can crowd and displace the tongue and also lead to future problems with TMJ disorders and sleep apnea.

You could look into epigenetic orthopedics with the DNA or MRNA Appliance as an alternative.

Also an evaluation for forward head posture is worthwhile.

Should I have 4 bicuspids extracted for orthodontic treatment?

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