Many patients have had teeth extracted prior to braces, to fit their remaining teeth into the dental arch. Often the wisdom teeth will still not fit in, and are also extracted. This is what happened to both my wife Deb and I.
This has been a popular orthodontic technique around the world but particularly in Australia, as one of the major proponents was an Australian orthodontic professor from Adelaide.
Many people who have had extractions and braces have no trouble, however some do develop problems as time passes. Problems that may be related to multiple tooth extractions include : -
* A "dished-in" profile where the nose and chin are well forward of the lips, with the nose appearing larger than it actually is - This has occasionally been termed a "Sydney Smile" and becomes far more evident with age
* A turned in (unsupported by the teeth) upper lip - Botox can help temporarily - but tipping the upper teeth back to where they should be is a permanent solution
* Dark corridors between the cheeks and the teeth when smiling (from a narrow dental arch)
* Worn down teeth from grinding, which can be from sub-consciously moving the jaw forward to open the airway (often when struggling to breathe when we are asleep)
* A feeling that the tongue wants to come further forward but is 'trapped'. Scalloping on the sides of the tongue from pushing against the teeth is common in Sleep Apnoea
* Old extraction sites that were closed with braces, and have re-opened by themselves, suggesting that the mouth is not big enough
* Head aches, neck aches and tooth aches - this can be due to clenching or grinding putting extreme pressure on the teeth and facial muscles and jaw joints (TMJ); and a sub-conscious change in head posture (usually well forward of the shoulders and tipped back) this opens the airway but places long term stress on the neck muscles
* Jaw Joint dysfunction such as a jaw that clicks or is painful - if the teeth are tipped in too much, when the jaw closes it is driven back too far causing damage to the joint area
* Obstructive Sleep Apnoea - if the jaw is too far back, then so is the tongue and when lying down the tongue can fall back over your airway and block off the air to your lungs either completely or partially. OSA on average reduces your life expectancy by 20% !
With orthodontics and either removable or cemented appliances, we can re-open the extraction sites, which can often give great relief from these symptoms and possibly save a surgical correction. This can potentially make you look better, feel better and live longer.
Even without having had extractions, either without any orthodontics at all, or having had braces to close natural gaps (such as missing teeth) - re-opening these spaces has the potential to help in many ways. One example of ours was a patient with regular "sinus infections", who after opening the site of a missing tooth has not had a sinus infection since, (5 years later). Studies have shown that any missing teeth at all (including wisdom teeth) have an increased risk of Sleep Apnoea.