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Q. The orthodontist advised extracting four teeth to treat high canines. Is it necessary?

Answered by
Dr. Disha Kandi Jain
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on May 18, 2020

Good morning My daughter (12 years) has high canines. The Orthodontist advised to extract 4 teeth before we start the treatment. I would like a second opinion to know if it is really necessary and if necessary which teeth bcs I read that the opinion differ to which teeth to extract especially in girls (to avoid saggy cheeks in the future.

Thank you. X-Rays taken five days back.

Dr. Disha Kandi Jain

Dentistry Naturopathy Orthodontist
# Hello,
Welcome to icliniq,
I have gone through your attachment and query, and I appreciate your efforts of taking images.

After reviewing X ray image of lateral cephalogram, there is proclination of upper and lower anteriors, highly placed canines and yes moreover there is crowding of upper and lower anteriors, when we consider soft tissue and profile of patients there is convexity of profile and potentially competent lips.

From above all findings it suggests that case will need extraction.
When one consider of labial Orthodontic treatment then according to me first premolars of all four quadrant should be extracted for alignment, leveling and space closure. As there is excess tooth material.

Again,I would like to see few more images like image of upper arch after opening of mouth widely and clicking from down,Images of lower teeth after opening of mouth widely and clicking from above,to evaluate space availability in full arch (anterior+posterior teeth) because in image one cannot find space availability in posterior segment.

Kindly get back with above details,so as to discuss further.
Thank you.
Take care.

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This are the pictures of the upper arch and the lower arch. We are wondering if it would be possible to extract the wisdom teeth or slowly increase the yaw bones rather than extracting teeth.

Dr. Disha Kandi Jain

Dentistry Naturopathy Orthodontist
# Hello,
Welcome back to icliniq,
I have gone through your attachment,
It is clear that tooth material is excess in upper arch and it will need extraction,and lower arch will also consequently need Extraction.
As you have enquired about third molar, according to OPG , development of third molar is not completed only.
second molars are also not fully erupted.
If there will be different case like distalization or something else then third molar extraction would be a option but not in this type of case.
Crowding is there in anterior side of arch and crowding will come in moderate category. So extraction of premolar will make it easier to resolve crowding.
Jaw growth and growth modification need to evaluate clinically for results but according to me as per images,growth modification will not help majorly for your case.

May I know,what is worrying you exactly?
What is your concern?
Is it esthetic or is it premolar or appearance after extraction?

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