Q. Why should four teeth be removed for orthodontic treatment, and how long does it take for the expander to work?

Hello,

Welcome to icliniq.com.

Hope you are doing well. I thoroughly read your query and understand your concern. Orthodontics has changed a lot since its inception about 120 years ago. Previously, it was a non-extraction protocol that was in the trend, followed by extraction protocols in the 1970s era, and now again, non-extraction protocols are preferred. Along with this, there has been a high impact and importance on the face esthetics that are given along with dental conditions. Coming to your case, we can see that there is a mild crowding that is present, which is evident by the presence of a canine tooth outside the arch as compared to other teeth. This situation can be dealt with in three possible ways with braces. First, extraction protocol wherein two premolars from the upper arch will be extracted. The teeth do not have brackets for the same purpose. Second, non-extraction with IPR. In this method, we do not extract the teeth but instead do something called interproximal reduction, IPR (grinding the teeth so that their width is reduced and some space is gained). Once IPR (interproximal reduction) is done, we will utilize the space and align the teeth in those spaces. Third, expansion with Damon's self-ligating system. In this method, Damon braces are used, which have shown expansion potential to some extent, and we do not need extractions. If expansion happens, we do not require IPR as well to gain the space. To decide on the extraction or non-extraction protocols, there are other factors to be considered as well. Age of the patient, severity of crowding in the jaws, face profile, etc. Expansion is more successful in younger ages till growth is present. Growth completes by 16 years for females and 18 for males. The severity of the crowding: Your case is not severe and can be managed without extraction (This is based only on the basis of attached occlusal photo) (attachments are hidden to protect the patient's identity). Face profile: Sometimes dental conditions can be managed non-extraction, but face profile demands extraction to improve it. Hence, this is an aspect I cannot say now. The reason why four teeth were told to be extracted is to maintain symmetry in the jaws. One tooth per arch will be extracted, and space closure will be done evenly on all four sides. To help you decide on the treatment plan better, I would require some extra details to assess and formulate a precise treatment plan for you. Feel free to reach out for further queries or related information clarifications. Hope I have answered your query. Regards. Regarding follow-up: Kindly share certain photographs for assessment. You can search on the internet how those photos look to assist you with photo clicks. Please send side profile of the face, frontal face, frontal teeth, lower occlusal, right and left lateral teeth.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Mayank Khandelwal

Experience: 2 + Yrs

Orthodontist

---

Related Questions:
Can orthodontic treatment be done without extracting teeth?

.. book, this is the only way the Orthodontist can make your face look symmetrical. Ideally, only four teeth are extracted as described by your dentist on each side of the jaw in crowded teeth but unfortunately, your fifth one is impacted so it has to go   Read full

After wisdom tooth extraction, when should I remove the gauze piece to avoid dry socket?

Hello doctor, I got my wisdom tooth extracted ... It has been 10 hours since the tooth had been take out ... Sipping can apply force on your   Read full

Post wisdom tooth extraction, I get a white patch of tissue near surgical site. Is that scar tissue?

Hello doctor, Approximately one week ago, I had my wisdom teeth removed ... I am currently on Celexa (for depression), 600 mg of Ibuprofen (for wisdom tooth pain) .   Read full