Is the Best Option for me to Replace Current Braces with Invisalign? (Photos)

I am a 16 year old girl. I have had braces for 15 months now. But I had to move with my family. Now the new dentist proposes 2 treatments because by continuing this treatment the front teeth will not come properly back he says and I do want them back. 1) remove one upper premolar each side to make space. And replace the current braces with ceramic braces. it will take two more years, 2) remove two upper premolars and use invisalign. It should take 2.5 more years. Thank you for your feedback.

Doctor Answers 8

I would discourage removing teeth if possible

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Many adult issues people are dealing with today (sleep apnea or TMJ issues, etc) is from having teeth pulled as a youth.  In some extreme cases pulling teeth is necessary, but it should not be common.  Judging from your photos I believe you can achieve what you desire without extractions, and should go that route.  I suggest finding another office for another opinion.

Should I get teeth out?

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I certainly would seek a few other opinions before changing treatment!  Certainly there are times when we start out without needing extractions and change our minds but after this length of time in treatment and the amount of upper spaces I see I would certainly get some confirmation from other docs

Robert Waxler, DMD, MS
Saint Louis Orthodontist

Removing Pre-molars

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PLEASE seek a second opinion before agreeing to any further treatment. It would be beneficial to see photos of your face; but from what I see, you don't need any further space created and you DEFINITELY would not want to extract bicuspids to create that space. Extracting bicuspids will create far more space than you require and leave you with excess space and poorly angled front teeth.

Invisalign for Bicuspid Extraction Cases

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I have been using Invisalign since 1999 and love it... for most cases. There are just some conditions for which Invisalign is not ideal and closing bicusid extraction spaces is one of those. The biomechanics required to retract teeth (move them back) and keep their roots parallel is difficult to achieve with Invisalign alone. I know in my offce we would not prescribe clear aligners for bicuspid extraction cases at this time. Hopefully there will be a day where we'll be able to produce equal results with braces or aligners. We're just not there yet!

Greg Jorgensen, DMD, MS
Albuquerque Orthodontist

Removing teeth when there is space already

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You ask a great question ...thanks for providing the photos which help us give you an opinion.  From what I can see in these photos (and admittedly I do do not have x rays and have not examined you in person) you do not need upper bicuspid extractions.  By using careful "anchorage", which prevents the back teeth from slipping forward, it is possible to treat you to an ideal bite and smile.  I would definitely seek other opinions before gettting any upper teeth extracted.  Braces are your best option: Invisalign would not work as well as braces for your situation.

Brian Povolny, DDS, PhD
Seattle Orthodontist

Continuing with Invisalign or traditional braces followint relocation

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Good information has been given by the responding dentists.  Do not pull any teeth without at least 3 different opinions concurring with this direction and in your case I would go with  orthodontists for those opinions.  Don't be afraid to ask if treatment can be done without extractions as this should be the last resort.  There are many options I believe for you and your hesitancy is good.  Follow your feelings and if something doesn't make sense ask questions and get another expert opinion.  Good luck!

Braces may be better than Invisalign in this case

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Your new dentist probably has access to a lot more information aboout you and your teeth that we do from these photos (xrays, clinical exam, etc), so it is very difficult without these tools to give a true opinion.  Your first provider did a nice job setting up your bite in the back and getting you ready to bring the front teeth back, but an xray may show that this is not possible or healthy or stable without taking out premolars.  If all was fine with the information gathered from the xrays, your case could be finished in under the two year time frame.  If the teeth are to be extracted, then two years with braces or two and a half years with Invisalign may be correct.  You should ask your dentist what the pros and cons of the ceramic braces vs Invisalign are. It may be easier to get the result you want (bringing the front teeth back) with braces. Good luck!

Andrew Orchin, DDS
Washington DC Dentist

Replace current braces with Invisalign

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The first thing that I look at when I see the upper teeth is all the space that is there.  I can't imagine why you would need to remove any teeth at all.  It is hard to know the whole story without all of the information, but based on what I see, I would recommend staying in braces, keeping all of your teeth, and finishing that way.  The doctor has more control with braces than Invisalign.  If they insist that you need teeth out, you might want to see someone else for a second opinion. 

Blaine McLaughlin DDS

Blaine McLaughlin, DDS
Cedar Rapids Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.