Is It Possible to Reopen the Spaces from Braces?

Question

The treatment it's been almost a year already with braces, my face is too narrow and small because of the extraction of the 4 bicuspid, can i still reopen the space again? since all of the canine moves into the premolar spot, except the upper have space left from the canine haven't closes yet. I can see my face the more the space get closes the more my face get slimmer and looks horrible, should i stop the treatment now or i continues? No other ortho from tx wants to take my case bc of lawsuit.

Rob van den Berg, DDS, MS · Answer

This may be accomplished in two steps, without bridges or implants:

	
		Open up the space, broaden the dental arch and move the front teeth forward
	
		Close the space by moving the back molars forward using TADs anchorage


	This may also be an option for patients that had their ortho completed with extrations years ago.

Brian Povolny, DDS, PhD · Answer

Depending on your unique circumstances it might be possible to open up spaces that are closed or partially closed. Many factors come into play, and to really get an idea of what is both possible and in your best interest you should seek several opinions. If there was dental crowding before treatment it might be difficult to open enough space to fit implants (for example), but only an in-depth consultation will reveal the best approach.

Robert Waxler, DMD, MS · Answer

As the decision to extract 4 teeth is usually and all or nothing one, many patients can be borderline with different opinions as to whether the teeth need to be extracted.  There are good ways to minimize the retraction of the anteriors due to extractions and opening spaces should be a last resort as it will require 4 implants or 4 bridges!

	The FIRST thing I would do is get multiple opinions as to what should be done!.....don't ask them to treat you....just ask for opinions on what they think is right (you may have to pay for some consultations but it would be worth it.

Daniel Noor, DMD, PC · Answer

I am not sure of all the circumstances in your case but generally speaking...
	If you are young and have healthy gums and teeth (healthy periodontal tissue), you may open up the spaces. *

	
	We have taken patients in the middle of treatment in the past but unfortunately many doctors and dentists have to be very careful helping patients in the middle of treatment because our system allows for many frivolous law suits but even if not, attorneys love to get everyone involved so the new doctor may have to spend countless hours in court for something he will never recover from!  As you know doctors are so busy seeing patients all day long and their time is very valuable. ... I wonder if you can ask an attorney, if you can sign a document promising that you will never involve your new doctor in a law suit in your case. Only then someone may take your case?! It&rsquo;s worth giving it a try. Ask an attorney because I am not one!

	
	Also, if you have a good relationship with your current doctor, ask him or her to see if they can or if they are willing to (if they think it&rsquo;s a good idea) to open up spaces..... They may have had a good reason to extract and  there is no way anyone can tell without a full exam and diagnostic records....It&rsquo;s always good to resolve things amicably.  Once again your current treating doctor may have had all the great reasons for extraction and closing of the spaces although immediate results may not be so pleasing! Depending on how your relationship is with your current doctor, you should discuss your concerns first and trust opinion of most doctors as I would believe and hope majority of doctors have the patient&rsquo;s best interest in mind no matter what! 

	It may not be a bad idea to close that little space you have left since at this point it does not make much of a difference and give yourself some time to really think if you want to open up all spaces again! You may be just fine with spaces closed after a while especially if you are in teen years and you will have a chance to at least get other&rsquo;s opinion&hellip;.Perhaps other doctors can give you their opinion even if they do not want to treat you.  Good luck.

	***Online Answers should NEVER be substituted for a complete clinical exam and following advice of your treating doctors based on proper and full diagnosis and treatment planning.   There is no way anyone can properly diagnose and treatment plan a patient online without an in office exam and full diagnostic records.

Is It Possible to Reopen the Spaces from Braces?

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