extract unerupted tooth, or make space with braces?

I am in a position to get my crossbite fixed and unerupted tooth extracted along with straghtened teeth for £3000 via orthodontic work, (just need to sign now). Or get free NHS treatment where the tooth may not be extracted but rather space will be created for the enerupted tooth (which is lying horizontally), along with braces, but I dont know if the braces provided will just be to create the gap, or to fix my crossbite and straighten teeth as well.

Doctor Answers 2

Teamwork needed

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This is a complicated case that should involve the input from a team of people including you, your general dentist, an orthodontist and either an oral surgeon or periodontist, all of who will contribute to your case.  No one likes to lose a tooth unecessarily but you have to consider your options and choose the one you feel most comfortable with.  In today's world of dentistry, many times an implant is more predictable long term than a natural tooth.  This tooth appears to be impacted deep into the bone so you have to consider the bone that will be lost during the extraction or forced-eruption process.  Will one procedure be more conservative than the other in that respect?  This appears to be an upper canine tooth but it is hard to tell on the PAN you posted.  If it is, it should not be hard to expose and erupt it orthodontically.  I can speak from experience when I tell you not to extract it and leave the area as-is.  This tooth is very important for your chewing function and smile and without it both will suffer ( I know as mine was pulled as a child and I have been through orthodontics and implant placement to correct that).  No matter what choice you make, your orthodontist will need to create room for the tooth or an implant.  If you choose not to replace the tooth, it will be difficult for the orthodontist to correct the midlines of your smile but he should still be able to correct/improve the crossbite that you discussed. I cannot stress enough the need for a team approach to this case.

I hope this information was useful to you.  Good Luck!!

Philadelphia Dentist

Should I Save Or Pull An Impacted Tooth?

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The decision to remove a body part is not one that I take lightly! (I hope that my doctors have the same outlook too...) At first thought it might seem easy to just have the dentist remove it and the problem would be solved. I mean it will require braces, about three years, and a surgery to save a tooth like yours. Down the road, however, you may wish that you had saved that tooth. Replacing it may still require braces and either an implant or a bridge. There are many variables to consider when it comes to extraction; the health of the surrounding teeth, the amount of crowding, other missing teeth (like the two lower bicuspids that you are missing!), etc. You need to find an experienced orthodontist who can help you determine which option is best for you. Imagine if you decide to have the canine removed only to discover that the root of the lateral next to it is bad and it has to be lost too. Oops! It might be good to still have that canine available.

Greg Jorgensen, DMD, MS
Albuquerque Orthodontist

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.