to extract or not to extract?

[happysmile]

hello everyone, i'm brand new to this. i just had my invisalign consultation with my ortho and him, along with another ortho i saw recommended me extracting 4 bicuspids before i have my invisalign treatment done. i had no idea that this was so controversial so i went ahead with agreeing and i have my extractions scheduled for tomorrow!

i'm now having 2nd thoughts as i'm reading articles about "sunken" cheeks and lips as well as drastic face changes. i'm terrified this will happen to me.

my ortho assured me that i have enough "lip support". he's recommending this because what i really want to correct is that i have quite a big overjet and my teeth protrude forward that when my lips don't 100% close when not smiling.

please let me know your thoughts on this! will my face change for the worse? i'm already insecure as it is about my looks, and i don't want it to get worse!

[Sunny]

Happysmile this is quite a controversial subject, which is why ortho's take it so seriously and most are too careful with their work to make the wrong call in this area. For some people extractions are the only way to go, so if you're happy with the ortho you've chosen, please trust what's planned.

If you don't feel confident with your choice, please delay tomorrow's appointment and have a few more consults before chosing a person to treat you.

Also ... your jaw line will not change ... therefore the bone structure of your face will not change. If a person has had a large overjet and this is corrected by moving the teeth back in the exisiting jaw bone, this can cause a change of profile and it can take a bit of adjusting to this change. Often this is when people have regrets, as they forget the reason for ortho treatment is more about bite correction than it is looks. But ... once they get used to the changes, most are delighted with both outcomes.

Good luck and please think carefully about what you need to do next.

[MCOMarkhamOrthodontist]

If your lips do not close, and your teeth are protruding, you won't likely have to worry about sunken in features. One of the indications for extracting four premolars is for a protrusive profile. The amount of retraction is going to depend on how your orthodontist controls the way the space closes.

[angel9165]

I had 4 teeth pulled 15 years ago with the traditional braces I had and it did not change my face (or profile).

Good luck with your treatment, happysmile!

[Rosieee]

I have had two teeth extracted on my top arch - the gaps have almost closed but my profile looks sooo much better. Also Dr Tam - my lips did close and my teeth weren't protruding beforehand.