My orthodontist recommended 4 pre molar removal but I have only heard bad things about that. I have attached an image of my palate and I will write my orthodontist’s diagnosis
Diagnosis:
On examination, was found to have a class Ill malocclusion on a class III Mild skeletal base with a Average Frankfort-Mandibular angle. There was a 1mm overjet and reduced overbite. Crowding: Upper - Severe, Lower - Moderate. An OPT was taken to aid diagnosis and treatment planning (attached). The IOTN was judged to be 4d / 7. Following discussion of treatment options available, including the option of no treatment, an NHS treatment plan was agreed as follows: - Upper and lower fixed - Extraction of all 4s - interarch elastics - bonded and removable rets Objectives: - level, alignrelieve crowding - establish positive OJ and OB - correct crossbite, improve centreline - retain We had taken clinical records and applied for NHS prior approval. I am pleased to report that NHS approval has now been granted. I would be very grateful if you could arrange to see at your convenience and extract: - all first permanent premolars: URA (14), UL4 24), LL4 (34), LRA (44)
Yes
Getting Marpe was one of the best decisions I’ve made & my palate looked less narrow than yours. I can breathe thru. Both my nostrils now, I’m not congested when I wake up. I don’t bite my tongue on the sides. I feel I pronunciate words better, too!
What was your starting inter molar width and where are you at now?
Palatal expansion is a good idea imo, saving your molars and correcting the crossbite in the process.
Why are we still encouraged to take our teeth out!! Its so annoying
Yes. Go to an airway ortho. No ortho should be recommending extractions. Crowding means your jaw is too narrow and should be expanded to accommodate your teeth.
Do not extract healthy teeth solely on only one orthodontist’s advice. This is irreversible and may not be necessary.
My first orthodontist suggested extractions of all 4 canines as they were blocked out of the arch from crowding (very similar to your top left canine). Canine extractions sounded crazier than leaving my teeth crowded as they were, and that’s what I did for years.
Three more orthodontists talked about premolar extractions within the first 10 mins.
I finally went with an orthodontist that was strongly against premolar extractions and sold me on MARPE even as 39M. I’m still going through braces, but so far the change has been incredible. All of my teeth are now in the arch, but still working on fixing an overjet.
Thanks for the reply. How long have u had braces for?
12 months so far. They gave me estimate of 18-24 months, but it’s probably going to be 24 if not a bit longer. This could have gone faster with extractions but I’m willing to take the extra time if it means keeping my teeth and less risk.
Yes you should look at getting palate expansion and no you should not have any healthy teeth extracted. Unless your speaking to a high level Ortho, most people in the NHS are working off old principles. The palate can be expanded to make space for teeth and even without palate expansion the use of tads, elastics, and other advaned modern techniques can be used to shift teeth around to create space. Do not get anything extracted.
Definitely needed.
Yes