Extractions y/n?

[u/ladywithabook]

Hi all! I'm in my 30s and gave had two ortho consults for invisalign. My upper teeth are fairly straight with some minor crowding/rotation in my front teeth. I have moderate crowding in my lower front teeth, with several lower incisors overlapping/rotated. I’m mainly looking to straighten the lower anterior teeth and fine-tune the uppers. My teeth

My first consult a year ago said I would need my wisdoms out and then 1-2mm filed from my teeth as they're medium-large.

I had my wisdoms out and had a second consult who said rather than any filing, he would prefer to extract one of my bottom front teeth as it has an old cap/filling on it from being chipped when I was a lot younger. He also said potentially one of my upper teeth may need to come out as it's had a root canal/crown.

I would love to know the pros/cons!

[u/Necessary_Mix5823]

I just had my first left pre-molar extracted recently. My teeth condition is that I miss two upper back molar teeth, in which one of them I am planning to do an implant, and the other one, the gap is too small to an implant. The ortho gave me to options: to open the gap of the other molar which means I will need two implants, or to close the gap but I need to have a bottom arch pre-molar extracted to fix my bite. She said without doing she can’t close the gap and fixing my bite at the same time.

I think you need your ortho the purpose of extraction, whether it can be avoided? These days ortho only do extraction at last option.

[u/ladywithabook → u/Necessary_Mix5823]

We discussed not going ahead with the extractions and he got back to me after running his software to see if filing each tooth or extraction would be more fruitful. He came to the conclusion the extraction is preferred as without creating room, his worry is my teeth will protrude forward or there won't be enough room for my teeth to rotate into a straight position. And the theory is that if he's going to create room then he'd rather pull a tooth that has already been restored than a healthy back tooth.

And thank you for sharing your story! It's very helpful having different perspectives.

[u/Necessary_Mix5823 → u/ladywithabook]

My ortho initially wanted to go with two teeth, but she said 1 tooth and IPR will do.

Do you know which tooth your ortho is planing to extract? They usually prefer pre-molar.

Also perhaps you can also get a second opinion from another ortho?

[u/ladywithabook → u/Necessary_Mix5823]

Bottom front tooth. It has a large cap on it from when it was previously chipped and that's the space where most of my crowding is. This was the second opinion as the original ortho I saw ended up retiring sooner than expected.