Overbite + missing 2nd premolars + jaw too far back problems... help?

06-21-2011, 12:50 AM

Firstly, I'd like to thank you for taking time to read this; I'm looking for advice since I'm in a quite troublesome situation...

The first problem wound be that my lower 2nd premolars are missing (they never grew back after the baby teeth came off). For that I got braces in order to re-align my lower teeth and to draw the 1st molar closer to the 1st premolar. Thinking that in this fashion I can avoid having implants or replacing the missing premolars with bridges (crowns?). Do you think that is a good idea? Or are my lower teeth end up dragged too far back (I'm no dentist, is it even possible for the braces to help the molar drag the front teeth backwards instead of the other way around?)?

My other problem is this time with the upper teeth (none of them is missing) which have had initially grown quite well. But now my wisdom teeth are coming out and have already crooked some of the teeth (esp. the incisors). Also, they pushed them further out. I have always had an overbite but now that my lower teeth are slightly straighter and the upper teeth are being pushed in front by the wisdom teeth, my overbite has turned quite big (I believe it's also 100%). The way I bite is naught but uncomfortable since the distance is so big (my orthodontist said I also have the jaw a bit far back). I will attach a few pictures. Now, to fix this, I have been told that I could either have the wisdom teeth removed (and leave the rest of the teeth as they are) or to have the 2nd premolar pulled out and get braces for the upper teeth as well ...and after some discussions, my orthodontist said it would be even more desirable to have the 1st upper molars pulled out, since they have had a lot of work done because of cavities, unlike the premolars which are perfectly healthy. Is it a good idea? Which one do you think would be better? Is there really NO way to fix my upper teeth unless I get the molars pulled out? Also, I'm pretty sure the orthodentist said my jaw is a little too far back... What should I do?
Other advice is most welcomed...

07-10-2011, 06:04 PM

Hi there,

Your teeth look good. I would advise not messing with it anymore, unless you feel pain in your jaws. Please don't do anything for aesthetic reasons alone.

I am a victim of orthodontal treatment gone wrong and so advice everybody to not get braces unless absolutely necessary. This doesn't look like a bad case to me. You are beautiful the way you are. Don't focus on your teeth.

Take care,
V

07-12-2011, 04:37 AM

without the xrays it is not possible to determine what the result of the ortho on the lowers is. but for certain, you are developing an exagerated overbite, class 2. this can be skeletal, or it can be due to the teeth arrangement alone, or it could be due to both. only the general dentist or orthod. could tell by taking some measurements and a couple more tracing xrays.

from everything you've included, removing the top 3rd molars is likely to be helpful. it stops the further migration forward of the of the uppers. it also allows you to better care for the 2nd molars. you are obviously young, and it is easiest to pull 3rds before age 25 or so becuase the bone gets more brittle with age and it's a more straightforward procedure if the bone has "give". if the 3rds already have decay, it would behoove you to have them removed for that reaon too, as they are very difficult to keep clean. (yes, it is technically possible to drag teeth both directions, but may not be practical or desireable. in your case, i have never seen uppers dragged back because that would affect your profile -- in realtion to your nose -- have a look and you'll see what i mean in the mirror.)

the xrays of the lowers would reveal if the molars have truly been moved forward or if they've been tipped forward instead (and likely to relapse and open that space back up, esp w/o a retainer). i see the canine has an unusual amt of wear and that could be from all this shifting as it's taking a harder beating than normal. (the canine is designed to take the hardest loads in the mouth for certain types of movement).

you might find after 3rds extraction that that is a sufficient treatment endpoint! i'd do that, if it were me, and see where the dust settles. you might want to have before, during, and after profile shots and casts taken so you can track the progress -- you just never know if you're going to move or change dentists in the future for any reason, etc. hope that helps!

Overbite + missing 2nd premolars + jaw too far back problems... help?

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