Should I get my 2nd upper premolars on each side removed? (Photo)

I have tmj + overbite.I had 4 impacted wisdom teeth removed when i was young. My last upper molars on each side doesnt touch my lower molars b/c of their position.I feel like my jaw is in a weird position to fit my bite,like its too "pulled back" and like my bite is "too deep".I feel more comfortable when I have my jaw slightly open and more forward.My Ortho wants to pull my upper premolars but I'm very attached to my teeth.Do you think I absolutely need to pull those 2 teeth to correct my bite?

Doctor Answers 2

Should I Extract Two Upper Bicuspids?

PLEASE do NOT extract any bicuspids. Any doctor who recommends extracting upper bicuspids and retracting incisors after hearing your chief complaints does not understand the relationship between TMJ health and tooth movement. 

Rounding out your upper dental arch and opening your bite will help resolve your TMJ issues. If your lower jaw is more comfortable in a forward position then let the lower jaw come forward. In order to do that you would NEVER extract bicuspids and retract upper incisors because that would push the lower jaw back even further. Let the lower jaw come forward by getting the upper incisors out of the way by straightening them.

Your case is pretty straight forward but make sure the treating doctor understands the relationship between tooth movement and TMJ/airway health as well as facial aesthetics. Who cares if your teeth are straight if your TMJ/airway are unhealthy and your face is less attractive.

Good luck!

Pulling upper teeth can lead to problems

If your jaw feels like it is too far back, and it is more comfortable open and forward, I would strongly recommend that you seek a second opinion.
In most cases when teeth are removed the orthodontic treatment must involve retracting teeth to close the space created.  Since the lower teeth sit inside the upper teeth, this can have the effect of making the lower jaw move back further to fit in.
For you who has TMJ issues already this could be very problematic.
Seek an orthodontist or general dentist who know how to expand the dental arch to create room for your jaw to move where it will be more comfortable, down and forward.

Martin Frankel, DDS
Toronto Dentist
3.7 out of 5 stars 3 reviews

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