Is Bicuspid Extraction Needed in my Case? (photo)

I am 28 year old female. My ortho suggested for 4 premolars to be removed. He told that without extraction the you wont be able to make out much of difference. My lower jaw is protruding out. Extraction will improve my bite and profile considerably.Will extraction cause change in my profile. My lower lips are broad it is because of protrusion? X ray shows that my lower wisdom tooth has grown in horizontal direction.Would extraction of wisdom tooth help instead of bicuspid removal. Please advice.

Doctor Answers 3

Premolar removal?

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Premolars should only be removed as a last resort as there are usually many other better options in this day and age.  The problem becomes much bigger when you remove premolars because the bite aligning is not ideal and patients can develop jaw problems.  Get several consults with different orthodontists and Invisalign providers before you consider having any teeth removed.  Removing wisdom teeth is generally recommended no matter what is done, but it will not correct your orthodontic problem in the front.  Good Luck!

Maybe extraction, maybe not

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Serene, of course no diagnosis can be made from just a few photos, but in general, extractions are more common in adults with crowded arches.  Kids who are growing can be influenced to grow more; adults can't.  What has to be planned well is what will your smile look like and how stable will your bite be after braces - if the front teeth are 'brought back' then will they just be too straight up and down or will they slant forward a bit, which is more natural and makes your lips look right.  The bite has to match how your jaws move and how your jaw joints work, so there isn't a real simple answer.  Taking out your wisdom teeth won't affect much of anything - that's a different decision.  Please keep interviewing orthodontists until you meet the one who will talk about how everything works together and begins with how it's going to be when you are finished.

Steve Carstensen, DDS
Bellevue Dentist

Bicuspid Extractions for Ortho

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I would get a few other orthodontic opinions. If you can do it without extractions, that would be my preference.

Jay Neuhaus, DDS
New York Dentist

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