Will Wearing a Bonded Expander at 23 Create Enough Space & Avoid Removal of 4 Bicuspids? (photo)

I am 23 years old and was told by my ortho thatI would have to wear an expander for 6 mnths but may also have to extract my bicuspids to create space. When I went to 2 other orthos for their opinion they both said that expansion would not work at my age and that it would be best to go straight to extraction. My ortho is completely against extraction on its own because he feel that it will not give me the "best smile." What should I do?

Doctor Answers 1

Expand or Extract?

E, this is a complicated question, and your dilemma about getting two opinions is a common one - so don't feel alone!

Expansion works great for growing people - so if you were 7, or 9, or 12, this is what most orthodontists would do. Unfortunately, at 23, your jaw just can't grow like it did back then, so if the teeth are pushed sideways with that expander, they tend to tip sideways - not make your jaw bigger.  This will create big troubles later.

On the other hand, taking teeth out will not help you have that big, wide smile that a lot of people find most attractive.  I can't see your whole face, so I don't know if this would be a great match for your body shape, but it is for a lot of folks.

So what to do?  There is yet a third alternative, that sounds very invasive but it is actually not so much. The oral surgeon, working closely with your orthodontist, goes under the skin on the roof of your mouth and separates the bone right where it used to grow.  Then your jaw can be expanded and the bone fills in the gap.  This sounds scary, but patients get through this just fine.  With this option, you get to keep all those beautiful teeth and you can have a nice wide smile.  There are a lot of details that have to be considered.

I think you should keep looking until you find an orthodontist willing to discuss this option with you - they will have a surgeon that they are used to working with that can help you get the information you need to make the best choice for you.

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