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Impacted Lower Cuspids and Lower Extractions

Looking at a glass filled with a bit of water as if it were half full is my way of life. This thought keeps the challenges doable not impossible.  As a doctor, I must weigh the benefits, risks, and burden of treatment relative to a desired effort. I am often asked to try to save teeth, not use certain appliances, forgo surgical options, or not take out teeth. None of these influence my vision to see the half full approach. The only request that helps fill my glass is for me to do the best I can do as if it were my son, daughter or wife.

 

 

Impacted canines are always troublesome. They can be stuck in positions within the upper or lower jaws that you couldn’t even imagine might look perfect one day. It’s not often that moving impacted teeth also involves the removal of lower teeth to accommodate the movement, but in the case of Taylor, we were faced with just that, which is one of the most challenging possible options, yet the best relative to the whole picture. Not only was I challenged with these two findings, Taylor’s lower teeth were already leaning forward too far in the lower jaw. Making room for more lower teeth, ie. the impacted lower cuspids, would have led to the lower front teeth being pushed out of the bone in the front of her lower jaw.

 

  

 

Taylor finished braces after 4 years. Was this worth the benefit, risks, and burden?  Even with a couple years of occasional tears, worry, and trust issues, I wouldn’t change a thing. Her finish is nearly perfect.   Taylor had two lower teeth extracted, lost no teeth due to movement of the severely impacted teeth, and kept her profile as full, if not creating an even fuller upper lip and stronger jaw projection in the end. My orthodontics actually purposely moved her upper smile closer to her lips and nose, decreasing the excessive gingival tissue exposed as a tiny girl. This allowed for the lower jaw to rotate further closed giving her the stronger lower jaw. This treatment was a half full choice…a choice no one else would try and no one else encouraged. I would do the exact same treatment for my family if faced with such a debacle and I am doing the same for most of your children as I write.

 

  

 

Before & After

Before After

Before

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