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Teeth crowding is a difficult bite problem (malocclusion) that often involves the entire jaw structure to be evaluated. Normally occurring when the jaw doesn’t have adequate space for normal tooth eruption, teeth coming in later put pressure on other teeth, causing them to develop improperly.
Crowding also makes it difficult to realign teeth with braces because there’s simply not enough room for sufficient movement to take place. The solution may then be to consider the removal of some of the teeth to create enough space for orthodontic treatment.
Not just any tooth can be removed, however — we must first conduct a careful analysis to determine which can be removed to facilitate optimum movement of the remaining teeth without disrupting normal mouth function or affecting appearance. The teeth most frequently removed for this purpose are the bicuspids, located between the cuspids or eyeteeth (which are positioned directly under the eyes) and the molars, the largest teeth in the back of the mouth. Sometimes one premolar tooth on each side of the jaw can be removed without sacrificing future form or function.
There are a few important considerations we must keep in mind when extracting teeth for orthodontic reasons; perhaps the most important is preserving bone at the extraction site. Because continuing bone growth depends on the forces generated by teeth when we bite or chew, bone near a missing tooth socket will tend to diminish over time. If there’s insufficient bone during orthodontic treatment, it may result in gum recession and root exposure — not only damaging to the teeth themselves but also to a person’s smile appearance. To avoid this, we sometimes will consider inserting a bone graft, which will stimulate bone growth, into the empty socket immediately after extraction. While this isn’t commonly done, it’s being considered if the patient’s bone is thin and a concern during healing.
We must also consider how to accommodate other, unrelated tooth loss to assure the final result is visually appealing. It may be necessary in these cases to maintain the space at the missing tooth site for a future restoration once the orthodontics is completed. This takes planning as well as the use of restorations like dental implants, bridges or partial dentures.
Regardless of your bite issues, the field of orthodontics has the appliances and techniques to overcome even the most complicated condition. When necessary, using procedures like tooth extraction can help turn an unappealing, dysfunctional bite problem into a beautiful smile.
If you would like more information on orthodontic teeth extractions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”
Plenty of parents use little tricks to persuade young ones to eat their vegetables, wash their hands, or get to bed on time. But when actress Jennie Garth wanted to help her kids develop healthy dental habits, she took it a step further, as she explained in a recent interview on Fox News.
“Oh my gosh, there's a froggy in your teeth!” the star of the '90s hit series Beverly Hills 90210 would tell her kids. “I've got to get him out!”
When her children — daughters Luca, Lola, and Fiona — spit out the toothpaste, Garth would surreptitiously slip a small toy frog into the sink and pretend it had come from one of their mouths. This amused the kids so much that they became engaged in the game, and let her brush their teeth for as long as necessary.
Garth's certainly got the right idea. Teaching children to develop good oral hygiene habits as early as possible helps set them up for a lifetime of superior dental health. Parents should establish a brushing routine with their kids starting around age 2, when the mouth is becoming filled with teeth. A soft, child's size toothbrush with a pea-sized dab of fluoride toothpaste and plenty of parental help is good for toddlers. By around age 6, when they've developed more manual dexterity, the kids can start taking over the job themselves.
Here's another tip: It's easy to find out how good a cleaning job your kids are doing on their own teeth. Over-the counter products are available that use a system of color coding to identify the presence of bacterial plaque. With these, you can periodically check whether children are brushing effectively. Another way of checking is less precise, but it works anywhere: Just teach them to run their tongue over their teeth. If the teeth fell nice and smooth, they're probably clean, too. If not... it's time to pull out the frog.
And don't forget about the importance of regular dental checkups — both for your kids and yourself. “Like anything, I think our kids mirror what we do,” says Garth. We couldn't agree more.
If you need more information about helping kids develop good oral hygiene — or if it's time for a checkup — don't hesitate to contact us and schedule an appointment. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”