Crowded teeth: is tooth extraction really necessary?

[Piglet68]

Some background: I have a relatively small jaw and as a child it was quite crowded. Dentist wanted to yank out several teeth. Mother freaked and found a dentist who was "anti tooth extraction" - he said it interfered with support of the jaw. He developed a technique using a retainer that you "cranked" wider every few days, just a millimeter at a time. Once things had widened up a bit, I had braces with headgear, then retainers, including one permanent one behind my four front teeth. Those teeth were never perfectly straight, and when that retainer finally fell out last year (over 20 years I had that thing!) I noticed my teeth got more crowded. Personally I could care less.

Present issue: DD, who is six, has my small jaw. Her baby teeth were already crowded. Now she's lost her two front lower teeth and the adult ones are obviously squished in there. Her dentist has warned me that she will almost certainly need teeth extractions and likely orthodontic work. I am LOATHE to yank out teeth, likely influenced by hearing the above from my ortho throughout my childhood. It was just drummed into me that tooth extractions were unnecessary and potentially destructive to the jaw structure (which supposedly led to "droopy mouth" syndrome - think Lois Lane from the old Superman movies).

Is this purely cosmetic? What are the consequences of having crowded teeth? She is blessed with my tough enamel - I've never had a cavity and so far she hasn't either despite not the most religious teeth brushing regimens!

[Sileree]

I agree, pulling out teeth for cosmetic reasons should be a last resort. Why not try the palate expander first? It worked for me before I got braces on at 14.

[WildIris]

I just talked about this in another thread; here's the link, it's post #9: http://www.mothering.com/discussions...d.php?t=963729

Based on my own experience, I would highly recommend pulling the teeth as opposed to going through the pain and expense of all that ortho work, which may or may not last in the long run.

[Piglet68]

I did a search of threads on this subject and saw that thread, WildIris. I see your point, but from what the dentist has told me pulling adult teeth will not prevent the need for orthodontic work in DD's case so I'm wondering about alternatives.

I think I will talk to our pediatric dentist about the jaw expander. He's a nice enough guy, and the practice is wonderfully child-friendly, but I'm sure he's very mainstream in his approach and I just question the need for all this willy-nilly yanking out of teeth (my neice had SEVEN teeth extracted, supposedly for crowding, and it just strikes me as one of those things we think is benign but we have those teeth for a reason, kwim?).

Just wondering if anybody else's children have had crowding issues (not overbites or decay issues) and what alternatives they found to just pulling out teeth...

[tomuchspade]

My dd teeth were widely spaced before permanent ones grew, but her x-rays showed really large teeth coming in and Dentist said there maybe crowding and may require ortho work, She did have to have some baby teeth pull when perm ones tarted growing ove them, but her teeth are perfectly straight, but still waiting for two teeth to come out. If not soon dentist will extract those. If you dd is going to be in pain then have it done, if not, take a wait and see approach.

[Piglet68]

Thanks, tomuchspade. So if she isn't in any pain, there aren't any decay issues...can anyone give me any reasons why she would need teeth extracted?

Also, difference between having adult versus baby teeth pulled? I can almost see pulling baby teeth, though I'm LOATHE to put my daughter through this as she tends to get very frightened of even the mention of such a thing, but pulling adult teeth....why? (if it's purely cosmetic)

[dawncayden]

From my experience (have crowded teeth and did the whole braces thing for 3 years, plus family members who also have 'stubborn' and crowded teeth)
I wish we had agreed to extract a tooth when my ortho had suggested it. He had suggested I extract one tooth, the one in the middle. I thought it was wierd to only extract one and not two, as there would be uneven teeth. Plus, since I was getting braces anyway, I thought it wasn't necessary.
I had my braces on for 3 years. It was painful. My teeth are really stubborn and seemed to fight the braces.
As soon as I got my braces off my teeth started to move back. Even wearing a retainer 24/7, it didn't seem to help.
So my teeth are pretty much back to square one. They are really jumbled/crowded and they are really crooked.
I'd really like to see what would have been different if I had the extraction.

This was when I was 13 yrs old btw, not 6. I wouldn't extract baby teeth only adult teeth.

[artparent]

piglet, my partner was told he would have many extractions to have braces for several years, as a teenager, but never pursued it. as an adult he saw dr.ara (can pm you) who 'slenderized' different teeth - he had nice wide teeth, so they could handle it, and it took only 6 months to straighten his teeth. it was pretty astonishing work, which i may pursue myself in future as my previously straight teeth have gone out of alignment in the last few years after i had two teeth extracted. at the moment we're moving around too much for intensive dentil dental work, so i'm just asking my teeth to move . ara is mostly working with children now.

*

[flowmom]

Piglet, that is really worrisome to contemplate healthy teeth being pulled! I think that you might find this article interesting, though some parts are somewhat fanciful and/or offensive:

Is it Mental or is it Dental? -- Cranial & Dental Impacts on Total Health

I guess my thought is that if there is a strong nutritional component to jaw development and the child's jaw is still growing, there is some hope for widening of the palate with proper nutrition including adequate vitamins D, A, and K?

Weston A. Price recommended the following:

• Orthodontics should include measures to widen the palate.
• Extract teeth only when necessary, and then in such a way as to avoid leaving the jaw bone with cavitations, which can be focal points of infection.

You can read the book in its entirety here:
Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects by Weston A. Price, MS., D.D.S., F.A.G.D. (1939)

You may want to get a second opinion from a progressive dental practice such as Nature's Design Dental Spa.

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[A&A]

Look at this website:

www.damonbraces.com

Search for an ortho in your area who does the Damon system. They can straighten your child's teeth/make room for all of the teeth, usually WITHOUT extractions OR expanders!!

And straightening teeth isn't purely cosmetic. Straight teeth are easier to floss and keep clean. And sometimes TMJ disorder can be caused by an uneven bite. But I agree that teeth shouldn't be pulled. Hence, I'm recommending this system (and my dd is in braces with a Damon ortho....so I'm walking the walk, not just talking the talk.)

[kathymuggle]

I really think having one or two teeth extracted (if that is all that is needed) is a much simpler solution than ortho. As per other thread - I have had a tooth extracted, and DH has had 2 (as a child - for overcrowding) and neither one of us has a droppy jaw....

I am not anti - braces, but I do think, in certain cases, extraction makes a lot more sense and is much easier on everyone. I wouldn't rule it out.

Kathy

[34me]

My dd's dentist is very anti pulling. I had 4 permentant teeth pulled so I was happy when he said that. My dd started with a cross bite so she had a palate expander when she was 4. She got braces at 12 because of crooked teeth and has a beautiful smile at 14.

[Piglet68]

Thanks again for your replies. Just to emphasize, this is not tooth extractions inSTEAD of braces. She would, according to her dentist, still need ortho even with the teeth pulling.

artparent - is that where they file off the sides of the teeth? the dentist has suggested doing that as a first step in making room for the new teeth, and I am comfortable with that. didn't know it could be an option in adult teeth, too. I'll look into that.

thanks everybody!

[kathymuggle]

In that case - how about braces first, and then see how the tetth are doing? Many people have several steps:

-palate extension, braces, retainer

How about reasessing between one of those steps?

Also - be firm on your goals. It may be, that in order to have Hollywood -perfect teeth, your DD does need an extraction. Lots of people go in for ortho for cosmetic reasons. the ortho might be operating under that idea.

However, if you and your DD are OK with a little crookedness - maybe ortho without braces is all that is needed?

I do not know - I am just specualting. Hope some of it helps!

[*Erin*]

i wish i'd had a tooth or 2 pulled before i had braces done. my bottom teeth are very crowded, and shifted right back into being crooked shortly after my braces were removed. when teeth are occluded like mine are, decay can easily form in the parts where the teeth touch/overlap. it's a PITA getting a filling between two teeth that are wedged together. i may get one pulled soon to fix the issue.

i say pull!

[cottonwood]

I have tight, overlapping teeth. I wore neckgear because my dentist said I "needed" it. My teeth are still tight and overlapped (I have a *really* small jaw) and I regret having tried to force them to be otherwise. I have zero doubt that my TMJ has to do with that -- I think the neckgear permanently altered and injured my jaw. I have one child who has tight, overlapping teeth like me and we are not going to do a thing about it. The dentist has said that his bite is fine (as is mine!) and it's just cosmetic. If it bothers him when he's older, he can make the choice to have them worked on then. But he doesn't care now, and I'm not going to assume that his future self would want me to make the choice for him to suffer for prettiness. My husband has pretty unattractive teeth by the usual standards -- they're widely spaced, oddly shaped, grooved and stained. But you know what? He's not in pain like me, and neither of us care that his teeth aren't pretty, and neither of care that my teeth aren't straight. We really, really just don't.

FWIW, I know a guy, middle-aged, who just had his teeth straightened. I can understand why he did it, but when I saw him with his new teeth I was surprised to find that he'd also lost quite a bit of character. Now he just looks like anybody else, very bland. I'm not saying that someone shouldn't fix their teeth to feel better about themselves, just that... it has a lot to do with perspective I guess. Perfection isn't always the most attractive thing.

[kangaroomum25]

I would at least try a very good cod liver oil and butter oil first. In fact I am doing that for my dd, her teeth aren't that bad yet but they need some straightening.

[Kirsten]

I WANT an ortho who is pro-pulling permanent teeth! Dd1's ortho doesn't want to pull any teeth, but I think it is a good idea since it worked so well for me.

I had four perm teeth pulled (second bicuspids) when I was ten or eleven I think it was, just prior to getting braces. Best thing ever! Didn't hurt - was much easier than it seems. And my braces straigtened my teeth - and they are still just darn near perfect 29 years later.

ALSO, when 90% of my friends in college were having wisdom teeth chipped out of their heads, I was fine. MUCH easier to have those second bicuspids pulled (I was awake; it was not a big deal at all) than what my friends went through with wisdom teeth extraction.

If my kids mouths look the least bit tight in relation to teeth fitting, I'd pull perm teeth without a second thought.