Question about tooth removal required for braces?

I have a friend who needs braces, and the ortho said that they will have to remove one tooth on the bottom due to the overcrowding. This patient's bottom back teeth (molar and bicuspids are all decently placed and aligned, but the front 6 teeth (incisors and canines) are like this: two central incisors are somewhat normally placed. Two lateral incisors are pushed back extremly far. The two canines are angled in and protrude out and obstruct most of the view of the two lateral incisors.





At first, we thought that the removal was to be of one of the lateral incisors, as the canine could be pushed to fill in most of that gap. Upon further review, it looks like the ortho actually chose one of the central incisors (24) to be removed.





I know nothing about dentistry, so I have two questions. 1) is removing one tooth normal? I'm worried about symmetry. 2) if it is, is removing a CENTRAL incisor normal??? (This patient is a professional and could use without a gap in the front!)

Question about tooth removal required for braces?
This is done more frequently in adults. In growing children it's usually first premolars that are removed.


But if the bite is generally good, this plan may be the easiest. From an appearance point of view, there's little difference between a lower central and lateral incisor.


Yes, obviously there will be symmetry problems, as you may not get exact midlines matching top to bottom. But if (as in most people) there is a bit of a normal overjet (upper teeth close over the lower teeth), it is unlikely anyone will notice unless they're looking for it.


If your friend has concerns, he/she should discuss them with the orthodontist. To me, it sounds pretty routine from your description.





Steve Bornfeld, DDS
Reply:it's not that bad to have the lower incisor removed:


http://www.public.iastate.edu/... Report It

Reply:No, I haven't heard of tooth removal for braces in a long time. They have devices that help with overcrowding. If I was your "friend" I would get a second opinion.
Reply:HELLO,


EVERY PATIENT IS DIFFERENT. WHEN THE CASE IS COMPLETED THE PATIENT WILL HAVE A VERY NICE SMILE. THE TWO CENTRAL INCISORS #24 AND #25


LOOK IDENTICAL, SO REMOVING JUST ONE WILL NOT ALTER THE APPEARANCE ONCE ALL THE TEETH ARE PROPERLY ALIGNED.


WHEN THE CASE IS FINISHED THERE WILL NOT BE A GAP OR OPEN SPACE LEFT BEHIND. ALL WILL BE WELL.
Reply:I agree with getting a second opinion, my teeth are very crowded also and I get my braces put on Dec 19th and I am an adult and my dentist said he is very against pulling any teeth.



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