News
Do I Have to Get My Wisdom Teeth Pulled for Orthodontic Treatment? <Reasons for Proceeding Without Extraction>
Hello, I'm Dr. Son Su-min, an orthodontic specialist at Guardians Dental Myeongdong, where I've been practicing for 20 years. Do you always have to pull teeth if you have wisdom teeth? This is a concern that many people who are considering orthodontic treatment at our clinic worry about during the consultation process. When looking at wisdom teeth, it seems like there's not enough space…
Hello.
I am Dr. Son Su-min, an orthodontic specialist who has been practicing at Guardians Dental Myeongdong for 20 years.
Do I have to extract teeth if I have crowding?
This is a concern that many patients who are considering orthodontic treatment for crowding at Jongno Orthodontic Clinic often worry about during the consultation process.
When you see crowding, it looks like there is not enough space, so you might think that you will eventually have to extract teeth.
To summarize, having crowding does not necessarily mean that you need to undergo extraction orthodontic treatment.
Today, I will explain why we did not extract teeth and how we secured the insufficient space through a real case of non-extraction orthodontic treatment for crowding.
Photos of the patient at the time of visit
Crowding often occurs when there is not enough space for the teeth to be arranged, causing them to overlap or be pushed out of the dental arch.
Therefore, in orthodontic treatment for crowding, it is essential to check how much space is lacking.
After examining how much space is lacking, the position of the front teeth, the width and bite of the dental arch, and the balance of the face, we determine whether extraction is necessary.
Why orthodontic treatment was needed
The patient's biggest concern was crowding.
The teeth were overlapping and arranged, and some of the front teeth were deviated from the normal dental arch.
Additionally, the lateral incisors (#12, #22) on both sides had a crossbite, where they bit in the opposite direction of normal.
For crossbite lateral incisors, it is crucial to adjust not only the direction of the tooth crown but also the direction of the tooth root.
Important points in orthodontic treatment for crowding
From the patient's perspective, the crowding that is visible when smiling may be the most concerning, but in orthodontic treatment, it is also important to consider how the teeth bite together.
If the front teeth are biting inward, it is not enough to simply pull them forward; instead, we need to create space for them to move and adjust the upper and lower front teeth to bite together naturally.
Therefore, the goal of this treatment was not only to correct the crowding but also to consider the following factors together: ① securing insufficient space ② arranging the crowding ③ adjusting the crossbite of the lateral incisors ④ adjusting the upper and lower teeth to bite together naturally.
Why did we choose non-extraction instead of extraction?
Just because you have wisdom teeth, it doesn't mean you need to extract them to secure space.
What's important is determining whether extraction is really necessary for the patient's current condition.
First reason, we considered changes in facial expression
If we had proceeded with extraction, the lower jaw would have become more prominent, making it possible for the face to look like it has an okni (protruding jaw).
Second reason, non-extraction was enough
Based on the examination results, we judged that the facial expression would improve positively just by aligning the teeth evenly without extracting any teeth.
The decision to extract or not depends on not only the lack of space but also the consideration of the patient's profile after treatment.
In particular, considering the current position of the front teeth and the balance of the face, we planned the treatment in the direction of non-extraction, securing only the necessary space while maintaining the current balance of the face as much as possible.
However, in cases where there is a significant lack of space, forced non-extraction can cause the front teeth to move too far forward, so it's essential to determine which method is suitable for the patient's current tooth condition and facial balance, rather than deciding what's better between extraction and non-extraction.
How do we create space for non-extraction orthodontic treatment?
Instead of extracting teeth, we can use various methods to secure the necessary space, depending on the patient's condition.
- Creating space in a narrow dental arch by checking the range of bone where the teeth can be placed, we can widen the narrow dental arch to create space for the wisdom teeth.
- Moving the molars backward to create space if there is enough space in the back, we can move the molar position slightly backward to secure space for the front teeth.
However, this is not possible for all patients, and we need to check the space in the back, the position of the wisdom teeth, the skeletal and occlusal state, etc.
- Interproximal reduction (IPR) in necessary cases, we can create space by trimming the teeth between them very slightly.
This method involves securing space by trimming a small amount from several teeth, rather than removing a lot from one tooth.
However, we need to consider the size and shape of the teeth, the condition of the enamel, etc., so we can't apply a fixed amount uniformly, but rather plan and apply it strategically only when necessary.
We utilized these methods according to the patient's dental arch and occlusal state to create space for the wisdom teeth.
After orthodontic treatment for protruding teeth
On the other hand, the small front teeth (#12, 22) that were protruding were not simply treated by pushing them forward.
The direction of the tooth roots in the gums as well as the visible part of the teeth were considered together to make the teeth sit more naturally.
The center line of the upper and lower teeth, which was deviated along with the protruding teeth, was also improved without extraction.
In conclusion
Orthodontic treatment for protruding teeth requires considering 1) facial balance evaluation, 2) direction and position of tooth roots, 3) whether space can be secured, and 4) whether extraction is necessary to establish a treatment plan.
In particular, if you are considering non-extraction orthodontic treatment, it is essential to focus on whether non-extraction is a suitable choice for your current condition, rather than just focusing on not extracting teeth.
If you are considering orthodontic treatment for protruding teeth at Guardians Dental Myeongdong, we recommend that you decide on the treatment direction that suits you after thoroughly checking your facial balance, tooth root direction and position, and whether space can be secured, rather than just deciding on extraction.
- From Dr. Son Su-min - ▼ Preview of Guardians Dental Myeongdong ▼
▼ Inquiry about concerns ▼
NAutomatically translated from the Korean post on our Naver blog. Read the original ↗