I took DD to two orthodontists recently and both talked about the move away from removing permanent teeth. Something about that being an old school practice. They also try to avoid removing baby teeth but in some cases may be necessary. As others mentioned 2nd opinion is good to have. Good luck OP.

How old is your child? Why are you doing all of this before any permanent teeth have emerged? The premolars should come in sometime between 9.5 and 10.5 and then assess from there.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP: thanks everyone, I will seek a second opinion particularly because this involves permanent tooth extraction which obviously cannot be reversed.

One thing I didn't mention in my first post is that DD's permanent teeth which haven't come in yet are positioned incorrectly in her gums so that her first molar is actually blocking the way for the canine to descend. So it may be the case that extraction is needed here even though it's generally not the ideal course of treatment.

I didn't mention it because it's unusual and I wanted to hear more stories just about the experience of extraction and space maintainers. I'd still be interested in hearing about it from anyone with experience.

Dentist here.
There are two adult teeth (the premolars) between the first permanent molar and the canine. If the molar is so close to the canine that it is blocking its descent, there is a whole lot more going on here. I have never seen this in my 20 years of practice. Are you sure this is being explained to you correctly?

OP: I'm sorry, I got the name of the tooth wrong, it's the first premolar, not the first molar. From my layperson google research, I believe that term used for teeth mixed up like this is transposition -- the first premolar and the canine are transposed. Does that make more sense? Though it's quite possible I'm still not getting the explanation right.

Ok that makes more sense. Is there any chance that an oral surgeon can uncover the canine and pull it down? Was that option given to you?

OP: I don't know, I'm not sure how, because the way teeth are (based on how it looked on the x-ray), the first pre-molar was pointed very diagonally and in the descent path of the canine, so how can the canine come down if the first premolar is in the way? It's blocking the path. Maybe there are methods, I don't know. The orthodontist was also saying the teeth were so crowded (big teeth, small mouth), there wasn't room, so this was what she was recommending.

Anyway, given the complicated situation and treatment, I will definitely ask her a lot of questions and seek a second opinion. So thank you for mentioning that as something I could ask about.

Remember, though, that x-rays are only 2 dimensional. The premolar could be in front of or behind the canine, therefore not actually “blocking” it. You would need better imaging (probably something like a CBCT) to get a better idea. It’s possible that pulling the canine down isn’t and option, just make sure you and the drs have all the information before deciding on treatment.

Good luck OP!

Definitely get a second and third opinion. My DS had a very complicated case and I literally got about six opinions just slowly over the course of the summer. I recommend Chris Liang, who has an office in Tenleytown and Potomac. He’s on staff at university of Maryland dental school as well. He even creates his own appliances as needed. He’s a bit of an engineer and is extremely good and up to date.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP: thanks everyone, I will seek a second opinion particularly because this involves permanent tooth extraction which obviously cannot be reversed.

One thing I didn't mention in my first post is that DD's permanent teeth which haven't come in yet are positioned incorrectly in her gums so that her first molar is actually blocking the way for the canine to descend. So it may be the case that extraction is needed here even though it's generally not the ideal course of treatment.

I didn't mention it because it's unusual and I wanted to hear more stories just about the experience of extraction and space maintainers. I'd still be interested in hearing about it from anyone with experience.

Dentist here.
There are two adult teeth (the premolars) between the first permanent molar and the canine. If the molar is so close to the canine that it is blocking its descent, there is a whole lot more going on here. I have never seen this in my 20 years of practice. Are you sure this is being explained to you correctly?

OP: I'm sorry, I got the name of the tooth wrong, it's the first premolar, not the first molar. From my layperson google research, I believe that term used for teeth mixed up like this is transposition -- the first premolar and the canine are transposed. Does that make more sense? Though it's quite possible I'm still not getting the explanation right.

Ok that makes more sense. Is there any chance that an oral surgeon can uncover the canine and pull it down? Was that option given to you?

OP: I don't know, I'm not sure how, because the way teeth are (based on how it looked on the x-ray), the first pre-molar was pointed very diagonally and in the descent path of the canine, so how can the canine come down if the first premolar is in the way? It's blocking the path. Maybe there are methods, I don't know. The orthodontist was also saying the teeth were so crowded (big teeth, small mouth), there wasn't room, so this was what she was recommending.

Anyway, given the complicated situation and treatment, I will definitely ask her a lot of questions and seek a second opinion. So thank you for mentioning that as something I could ask about.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP: thanks everyone, I will seek a second opinion particularly because this involves permanent tooth extraction which obviously cannot be reversed.

One thing I didn't mention in my first post is that DD's permanent teeth which haven't come in yet are positioned incorrectly in her gums so that her first molar is actually blocking the way for the canine to descend. So it may be the case that extraction is needed here even though it's generally not the ideal course of treatment.

I didn't mention it because it's unusual and I wanted to hear more stories just about the experience of extraction and space maintainers. I'd still be interested in hearing about it from anyone with experience.

Dentist here.
There are two adult teeth (the premolars) between the first permanent molar and the canine. If the molar is so close to the canine that it is blocking its descent, there is a whole lot more going on here. I have never seen this in my 20 years of practice. Are you sure this is being explained to you correctly?

OP: I'm sorry, I got the name of the tooth wrong, it's the first premolar, not the first molar. From my layperson google research, I believe that term used for teeth mixed up like this is transposition -- the first premolar and the canine are transposed. Does that make more sense? Though it's quite possible I'm still not getting the explanation right.

Ok that makes more sense. Is there any chance that an oral surgeon can uncover the canine and pull it down? Was that option given to you?

I had that done when I was a kid. It remember the pulling down process as being extremely painful but my teeth look good now! I’m glad my parents made orthodontia a priority. Good luck, OP!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP: thanks everyone, I will seek a second opinion particularly because this involves permanent tooth extraction which obviously cannot be reversed.

One thing I didn't mention in my first post is that DD's permanent teeth which haven't come in yet are positioned incorrectly in her gums so that her first molar is actually blocking the way for the canine to descend. So it may be the case that extraction is needed here even though it's generally not the ideal course of treatment.

I didn't mention it because it's unusual and I wanted to hear more stories just about the experience of extraction and space maintainers. I'd still be interested in hearing about it from anyone with experience.

Dentist here.
There are two adult teeth (the premolars) between the first permanent molar and the canine. If the molar is so close to the canine that it is blocking its descent, there is a whole lot more going on here. I have never seen this in my 20 years of practice. Are you sure this is being explained to you correctly?

OP: I'm sorry, I got the name of the tooth wrong, it's the first premolar, not the first molar. From my layperson google research, I believe that term used for teeth mixed up like this is transposition -- the first premolar and the canine are transposed. Does that make more sense? Though it's quite possible I'm still not getting the explanation right.

Ok that makes more sense. Is there any chance that an oral surgeon can uncover the canine and pull it down? Was that option given to you?

Anonymous wrote:

Anonymous wrote:OP: thanks everyone, I will seek a second opinion particularly because this involves permanent tooth extraction which obviously cannot be reversed.

One thing I didn't mention in my first post is that DD's permanent teeth which haven't come in yet are positioned incorrectly in her gums so that her first molar is actually blocking the way for the canine to descend. So it may be the case that extraction is needed here even though it's generally not the ideal course of treatment.

I didn't mention it because it's unusual and I wanted to hear more stories just about the experience of extraction and space maintainers. I'd still be interested in hearing about it from anyone with experience.

Dentist here.
There are two adult teeth (the premolars) between the first permanent molar and the canine. If the molar is so close to the canine that it is blocking its descent, there is a whole lot more going on here. I have never seen this in my 20 years of practice. Are you sure this is being explained to you correctly?

OP: I'm sorry, I got the name of the tooth wrong, it's the first premolar, not the first molar. From my layperson google research, I believe that term used for teeth mixed up like this is transposition -- the first premolar and the canine are transposed. Does that make more sense? Though it's quite possible I'm still not getting the explanation right.

Anonymous wrote:OP: thanks everyone, I will seek a second opinion particularly because this involves permanent tooth extraction which obviously cannot be reversed.

One thing I didn't mention in my first post is that DD's permanent teeth which haven't come in yet are positioned incorrectly in her gums so that her first molar is actually blocking the way for the canine to descend. So it may be the case that extraction is needed here even though it's generally not the ideal course of treatment.

I didn't mention it because it's unusual and I wanted to hear more stories just about the experience of extraction and space maintainers. I'd still be interested in hearing about it from anyone with experience.

Dentist here.
There are two adult teeth (the premolars) between the first permanent molar and the canine. If the molar is so close to the canine that it is blocking its descent, there is a whole lot more going on here. I have never seen this in my 20 years of practice. Are you sure this is being explained to you correctly?

How old is your DD? If no permanent teeth have come in yet, there is a lot of assumptions being made about how it could work out. Couldn't they at least try to make room in the palate with an expander?

OP: thanks everyone, I will seek a second opinion particularly because this involves permanent tooth extraction which obviously cannot be reversed.

One thing I didn't mention in my first post is that DD's permanent teeth which haven't come in yet are positioned incorrectly in her gums so that her first molar is actually blocking the way for the canine to descend. So it may be the case that extraction is needed here even though it's generally not the ideal course of treatment.

I didn't mention it because it's unusual and I wanted to hear more stories just about the experience of extraction and space maintainers. I'd still be interested in hearing about it from anyone with experience.

I had a lower front tooth pulled (I have only 3 incisors on the bottom between canines) and a wire glued to the canines to keep things spaced correctly. I was probably 10 for the extraction, and then in high school I got braces for a year or 18 months. I'm 40 now. The wire is still there, which my dentist always marvels at. You are supposed to use special floss to get under it but I am lazy and don't.

I've had no problems, but I also was under the impression they don't do this anymore. I would seek a second opinion.

I would ask about the consequences of leaving it alone and getting braces later; my mom did invisilign when she was 50+ so does all this dental work need to happen right now? Maybe it does but I'd ask for an explanation.

I had permanent teeth (my 12 year molars) pulled as part of my orthodontic treatment when I was a young teen. My teeth are messed up now and I should probably get braces again--this is after 4 years of braces in middle-high school. I would get second and third opinions.

I would get a second opinion on this issue.

My ds is facing some orthodontia, and his dentist explained that there have been some negative outcomes over time in people who had permanent teeth removed as adolescents in order to make space. It can result in bone problems over the years. He said the dental industry in general is moving away from pulling permanent teeth as a common practice (that’s not to say that it isn’t sometimes necessary).

Maybe it would be appropriate in your dd’s case, but if I were you I would want to be as certain as possible before moving ahead with pulling permanent teeth; it isn’t without possible consequences.

I'm just looking for people who have BTDT. My DD has very crowded teeth -- the orthodontist has said that some permanent teeth (the ones next to the canines) should be pulled so that there is room for the teeth. Apparently a palate expander will not work for her. In addition, they can see that some teeth are not positioned to come in straight, so they want to pull some baby teeth, and put in space maintainers so that teeth will come in properly. The last step is for the teeth to be straightened with braces.

This was all sent to me in an email from the orthodontist, so I haven't had the chance to speak to her yet. I will, I definitely have a lot of questions. I would just like to hear from anyone who has done something similar about how it all went -- was it a big hassle for your kid and you? How long did they have a space? Did the teeth look ok afterward?