Question about extractions!

[ecoons]

My orthodontist said that i will have to have my first 2 bi-cuspid teeth removed but he wanted to do it after my appliances were already on. Im wondering why he doesn't want me to do it before the braces and if it's going to hurt like hell if they pull them a week after my braces get put on? clueless..

[Denise]

My ortho did the same thing to me. He just wanted to get the brackets on, then they did the extractions, and a week later I had the arch wire put in. When they put the brackets on, they did top and bottom and put the lower wire in, so the follow up appointment only took about five minutes. So perhaps they are just wanting to save time by doing it all at once? Sunny will probably have a better answer as to exactly why they put brackets on before the extractions, but I know it's very, very common.

[MCOMarkhamOrthodontist]

Couple of reasons for braces first, then extractions:

1. If your brackets are placed using indirect bonding, extractions should be performed after to ensure that teeth do not shift from the time impressions are taken, to the time braces are placed.

2. With brackets on the teeth, it becomes very easy for the general dentist/oral surgeon to know which teeth to remove. This provides a kind of "safety" to make sure the proper tooth is removed.

3. Sometimes teeth are not removed until arches are aligned. Generally, space closure does not begin until most of the teeth are straight. The reason for this is that forces required to close space must be performed on larger, stiff wires. These cannot be placed until after alignment has been achieved. By delaying extractions as close as possible to the time when space closure will occur, it allows more rapid space closure, as the bone in the extraction site has not had a chance to fill in and impede tooth movement. Also, with some mild trauma to the area, there will be many of the blood factors in the area, also accelerating bone remodeling (in a concept similar to corticotomies).

4. If teeth are extracted far before braces are placed, they may begin to move in an uncontrolled fashion.

5. Some orthodontists do not want to refer patients for extractions prior to bracketing, since there is still some chance that orthodontic treatment may not occur, in which case there is now a patient walking around with gaps between their teeth. Extractions are final, so the doctor will want to make sure that the patient is going to go ahead with treatment before having teeth taken out.

There are likely more reasons, but these are probably some of the more common. Hope it helps!