Is tooth extraction required for lower teeth alignment?

Question

Hello doctor,

My orthodontist advised the removal of the front lower teeth to segregate the alignment. I would like to send you the photographs. Kindly suggest if it is necessary.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Removing one tooth from the lower arch, according to the orthodontist, may correct the problem. But it can only get worse. The patient has a condition called class II division 2 malocclusion, where her upper front teeth are inclined towards the inside. This causes a restriction for the lower arch to grow to its potential. As the jaw is not developing, the teeth get less space, and they erupt in other places, causing crowding in the arch.

I advise you to follow the instructions below.

Do not extract any teeth for now, and do not make any changes in the lower arch at all.
Start the treatment on the upper arch and procline the upper front two teeth.
Once they come a bit forward, we will have space to adjust the teeth next to them, called lateral incisors, and the lower arch will not have any obstruction to grow forward.
Once you get sufficient proclination and lower jaw growth, a re-assessment would be done to assess the actual space required and the need for extracting the teeth.
This whole process should take about three to five months with sufficiently proclined upper teeth, and the treatment can be started on the lower arch.
Upper teeth can be proclined by the following methods:
1. 2x4 appliance.
2. Protraction utility arch.
3. Reversing the brackets.

Kindly consult a specialist, talk to them, and follow the advice.

I hope this information will help you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Sorry for the delay in responding; I was preoccupied with other engagements. No, I do not have the option of sharing any attachments here. These treatment modalities can also be researched online for a better understanding.

These will be placed on the upper jaws as they are locking the lower jaw to develop. Once the upper front teeth are taken a bit forward with better angulation, the lower jaw gets space to move forward and expand on its own.

Thus, the upper jaw needs treatment first. As the upper teeth come to better alignment, we get a better idea on exact status of the lower jaws and how much they respond naturally to our intervention on the upper jaws.

I hope this clarifies your concerns.

Please feel free to reach out anytime if you need further assistance.

Thank you.