Should I Stop Wearing my Retainer?

Question

I had 4 extractions to fix my overcrowding. Now I am very unhapppy with my smile as my teeth retracted way too far in and my teeth almost do not show when I smile.. I am getting depressed looking in the mirror. Should I stop wearing my retainer and if I do so will my teeth move back? And then perhaps get a crown to fill the gap if the teeth move back to previous position?

Brad Lockhart, DDS · Answer

This is one of the most common and tragic stories I hear whenever extractions and orthodontics are talked about together. Without even asking I can say that the four teeth you had extracted were bicuspid teeth. When this type of treatment is done then the problem of overcrowding is fixed but a bigger problem of excess space is introduced. By taking out four bicuspid teeth you create more space than is necessary to unravel your teeth. Unfortunately, you are faced with overly retracted teeth, a nose that might appear longer than it used to, a chin that probably looks too retruded, lips that look small, black spaces in the corner of your smile and a possible TMJ problem to boot. I feel so bad for you and all of this should have been discussed with you BEFORE treatment proceeded. The only thing not wearing your retainer would do is make your teeth crooked again. They will NOT move back to where they were. Your best bet is to continue wearing your retainers. The only way to fix the problems that were introduced by extracting the teeth is to move the teeth back and do some kind of cosmetic restorations or even dental implants. If ANYONE within the sound of my voice is considering bicuspid extractions in conjunction with orthodontics, PLEASE seek a second and third opinion BEFORE proceeding.

Robert Waxler, DMD, MS · Answer

I can not help but respond to the answer given by Dr. Lockhardt.  Yes it is possible to misdiagnose or mistreat a patient with bicuspid extractions...just as it is possible to kill a patient when you do an appendix operation!  Nonetheless, properly done and treated for the right patient, extractions can be the correct treatment.  There have been many good scientific studies that have shown that extraction treatment does not cause all of the problems he attributes to this "tool".Just because he can show a few cases that didn't work out is not a reason to condemn an accepted and valuable tool of orthodontic treatment.

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